MEDICARE: FAMILY PHARMACY CENTER INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1295544799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PHARMACY CENTER INC.

Provider Business Mailing Address
First Line	:	220 W MAIN ST STE 102
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-3462
Country	:	US
Telephone Number	:	619-383-6788
Fax Number	:	619-383-6706

Provider Business Practice Location Address
First Line	:	220 W MAIN ST STE 102
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-3462
Country	:	US
Telephone Number	:	619-383-6788
Fax Number	:	619-383-6706

Authorized Official
Title or Position	:	CEO
Name	:	NOOR MIKHAIL
Credential	:
Telephone Number	:	619-905-7722

Provider Enumeration Date	:	12/31/2024
Last Update Date	:	01/06/2025

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