MEDICARE: COMMUNITY FAMILY PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	082000	NC
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043204902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY FAMILY PHARMACY

Provider Business Mailing Address
First Line	:	1194 WYKE RD
Second Line	:
City	:	SHELBY
State	:	NC
Zip	:	28150-4259
Country	:	US
Telephone Number	:	704-482-4457
Fax Number	:	704-487-5427

Provider Business Practice Location Address
First Line	:	1194 WYKE RD
Second Line	:
City	:	SHELBY
State	:	NC
Zip	:	28150-4259
Country	:	US
Telephone Number	:	704-482-4457
Fax Number	:	704-487-5427

Authorized Official
Title or Position	:	OWNER
Name	:	CARLA BEAM
Credential	:
Telephone Number	:	704-300-7197

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	11/07/2023

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Directions to “COMMUNITY FAMILY PHARMACY ” Practice Location

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