MEDICARE: FAMILY CARE 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	025560	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3329340	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487642062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE PHARMACY INC

Provider Business Mailing Address
First Line	:	995 ROUTE 22
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-1526
Country	:	US
Telephone Number	:	845-279-2931
Fax Number	:	845-279-2098

Provider Business Practice Location Address
First Line	:	995 ROUTE 22
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-1526
Country	:	US
Telephone Number	:	845-279-2931
Fax Number	:	845-279-2098

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEEVA THOMAS
Credential	:
Telephone Number	:	845-279-2931

Provider Enumeration Date	:	10/08/2005
Last Update Date	:	01/13/2010

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