MEDICARE: FAMILY HEALTH PHARMACIES INC

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	3336C0004X	Compounding Pharmacy
2	3336L0003X	Long Term Care Pharmacy
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	3336C0003X	Community/Retail Pharmacy	2016042402	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2049810	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780754440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HEALTH PHARMACIES INC

Provider Business Mailing Address
First Line	:	301 GEORGIA ST
Second Line	:
City	:	LOUISIANA
State	:	MO
Zip	:	63353-1717
Country	:	US
Telephone Number	:	573-754-4551
Fax Number	:	573-754-6934

Provider Business Practice Location Address
First Line	:	301 GEORGIA ST
Second Line	:
City	:	LOUISIANA
State	:	MO
Zip	:	63353-1717
Country	:	US
Telephone Number	:	573-754-4551
Fax Number	:	573-754-6934

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHARI BLACK
Credential	:
Telephone Number	:	573-754-4551

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	01/20/2017

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Directions to “FAMILY HEALTH PHARMACIES INC ” Practice Location

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