Provider Demographics
NPI:1720312911
Name:FAMILY PHARMACY INC.
Entity Type:Organization
Organization Name:FAMILY PHARMACY INC.
Other - Org Name:FAMILY PHARMACY #24
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:TENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-581-4335
Mailing Address - Street 1:1300 E, PENNELL ST.
Mailing Address - Street 2:
Mailing Address - City:CARL JUNCTION
Mailing Address - State:MO
Mailing Address - Zip Code:64834
Mailing Address - Country:US
Mailing Address - Phone:417-649-7600
Mailing Address - Fax:417-649-7518
Practice Address - Street 1:1300 PENNELL ST
Practice Address - Street 2:
Practice Address - City:CARL JUNCTION
Practice Address - State:MO
Practice Address - Zip Code:64834-9478
Practice Address - Country:US
Practice Address - Phone:417-649-7600
Practice Address - Fax:417-649-7518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy