Provider Demographics
NPI:1891118691
Name:FAMILY CARE PHARMACY LLC
Entity Type:Organization
Organization Name:FAMILY CARE PHARMACY LLC
Other - Org Name:FAMILY CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANUJA
Authorized Official - Middle Name:
Authorized Official - Last Name:KATTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-862-3945
Mailing Address - Street 1:46300 LEXINGTON VILLAGE WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-5561
Mailing Address - Country:US
Mailing Address - Phone:301-862-3945
Mailing Address - Fax:301-862-3946
Practice Address - Street 1:46300 LEXINGTON VILLAGE WAY STE 104
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-5561
Practice Address - Country:US
Practice Address - Phone:301-862-3945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP064933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2144087OtherPK