Healthcare Provider Details

I. General information

NPI: 1487962676
Provider Name (Legal Business Name): FAMILY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 W BROWARD BLVD
FT LAUDERDALE FL
33312-1113
US

IV. Provider business mailing address

3230 W BROWARD BLVD
FT LAUDERDALE FL
33312-1113
US

V. Phone/Fax

Practice location:
  • Phone: 855-873-7989
  • Fax: 954-794-0657
Mailing address:
  • Phone: 855-873-7989
  • Fax: 954-794-0657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH24954
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NERMEEN GIRGIS
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 954-354-0530