MEDICARE: FAMILY PHARMACY 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	716	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0609199	OTHER		OTHER ID NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407957848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PHARMACY INC

Provider Business Mailing Address
First Line	:	PO BOX 470367
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80047-0367
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1718 S CHAMBERS RD
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80017-5023
Country	:	US
Telephone Number	:	303-695-1702
Fax Number	:	303-367-1825

Authorized Official
Title or Position	:	OWNER AND PRESIDENT
Name	:	LEONARD MCGINNITY
Credential	:
Telephone Number	:	303-695-1702

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	09/13/2007

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