Provider Demographics
NPI:1649670308
Name:FAMILY MEDS PHARMACY INC.
Entity type:Organization
Organization Name:FAMILY MEDS PHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DALIA
Authorized Official - Middle Name:GAMALELDEIN HASSAN
Authorized Official - Last Name:ELGOHARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-459-9337
Mailing Address - Street 1:302 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:MARINE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48039-1689
Mailing Address - Country:US
Mailing Address - Phone:312-459-9337
Mailing Address - Fax:
Practice Address - Street 1:302 S WATER ST
Practice Address - Street 2:
Practice Address - City:MARINE CITY
Practice Address - State:MI
Practice Address - Zip Code:48039-1689
Practice Address - Country:US
Practice Address - Phone:312-459-9337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-01
Last Update Date:2014-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy