Provider Demographics
NPI:1942387626
Name:FAMILY HEALTH PHARMACY INC
Entity Type:Organization
Organization Name:FAMILY HEALTH PHARMACY INC
Other - Org Name:FAMILY HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYETT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:205-698-9770
Mailing Address - Street 1:PO BOX 505
Mailing Address - Street 2:P O BOX 505
Mailing Address - City:SULLIGENT
Mailing Address - State:AL
Mailing Address - Zip Code:35586-0505
Mailing Address - Country:US
Mailing Address - Phone:205-698-9770
Mailing Address - Fax:205-698-8522
Practice Address - Street 1:55298 HIGHWAY 17
Practice Address - Street 2:55298 HWY 17
Practice Address - City:SULLIGENT
Practice Address - State:AL
Practice Address - Zip Code:35586-3838
Practice Address - Country:US
Practice Address - Phone:205-698-9770
Practice Address - Fax:205-698-8522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1038563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100001540Medicaid
1990470OtherPK