=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326125600
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILY DRUGS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2006
-----------------------------------------------------
Last Update Date | 04/29/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 810 W COMMERCE ST
-----------------------------------------------------
City | BROWNSTOWN
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47220-1200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-358-4502
-----------------------------------------------------
Fax | 812-358-4503
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 810 W COMMERCE ST
-----------------------------------------------------
City | BROWNSTOWN
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47220-1200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-358-4502
-----------------------------------------------------
Fax | 812-358-4503
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. SCOTT E BUTT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 812-358-4502
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 100297490A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332BP3500X
-----------------------------------------------------
Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
-----------------------------------------------------
License Number | 60004121A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336H0001X
-----------------------------------------------------
Taxonomy Name | Home Infusion Therapy Pharmacy
-----------------------------------------------------
License Number | 60004121A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 60004121
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------