Healthcare Provider Details
I. General information
NPI: 1629001201
Provider Name (Legal Business Name): FAMILY CENTER PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2006
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4000 HEMPFIELD PLAZA BLVD SUITE 966
GREENSBURG PA
15601-1483
US
IV. Provider business mailing address
3802 CORPOREX PARK DR STE 200
TAMPA FL
33619-1125
US
V. Phone/Fax
- Phone: 724-836-5749
- Fax: 724-836-8414
- Phone: 813-318-6039
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | PP414220L |
| License Number State | PA |
VIII. Authorized Official
Name:
ALLISON
L.
BROWN
Title or Position: SECRETARY
Credential:
Phone: 502-630-7429