Provider Demographics
NPI:1891886974
Name:FAMILY DRUG PHARMACY, INC
Entity Type:Organization
Organization Name:FAMILY DRUG PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/ CHIEF PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:586-200-2723
Mailing Address - Street 1:19011 E 10 MILE RD STE B
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-3901
Mailing Address - Country:US
Mailing Address - Phone:586-200-2723
Mailing Address - Fax:586-200-2688
Practice Address - Street 1:19011 E 10 MILE RD STE B
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-3901
Practice Address - Country:US
Practice Address - Phone:586-200-2723
Practice Address - Fax:586-200-2688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010076163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy