Healthcare Provider Details

I. General information

NPI: 1699052720
Provider Name (Legal Business Name): FAMILY FIRST PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 MAIN ST
BAYBORO NC
28515-9634
US

IV. Provider business mailing address

702 MAIN ST
BAYBORO NC
28515-9634
US

V. Phone/Fax

Practice location:
  • Phone: 252-745-5539
  • Fax: 252-745-5797
Mailing address:
  • Phone: 252-745-5539
  • Fax: 252-745-5797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number10654
License Number StateNC

VIII. Authorized Official

Name: LORI BRINSON ALTMAN
Title or Position: PHARMACIST/PRESIDENT
Credential: PHARMD
Phone: 252-745-5539