Provider Demographics
NPI:1780920884
Name:FAMILIA CARE INC
Entity type:Organization
Organization Name:FAMILIA CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER, PHARMACY OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:BARTLEMAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:972-207-4922
Mailing Address - Street 1:300 E JOHN CARPENTER FWY
Mailing Address - Street 2:SUITE 850
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-2727
Mailing Address - Country:US
Mailing Address - Phone:972-957-3000
Mailing Address - Fax:
Practice Address - Street 1:4200 SOUTH FWY
Practice Address - Street 2:SUITE 106
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-1400
Practice Address - Country:US
Practice Address - Phone:817-566-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy