Healthcare Provider Details

I. General information

NPI: 1679111074
Provider Name (Legal Business Name): FAMILY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2019
Last Update Date: 12/16/2019
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10503 W THUNDERBIRD BLVD STE 101B
SUN CITY AZ
85351-2719
US

IV. Provider business mailing address

6720 N 61ST AVE
GLENDALE AZ
85301-3109
US

V. Phone/Fax

Practice location:
  • Phone: 623-974-3555
  • Fax:
Mailing address:
  • Phone: 602-800-3336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LOUY M AL ATTEELI
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 602-800-3336