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NPI Code Detail

MEDICARE: FAMILY MEDICAL PHARMACY, LLC

MEDICARE: FAMILY MEDICAL PHARMACY, LLC
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
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1962265769
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY MEDICAL PHARMACY, LLC
Provider Business Mailing Address
First Line : 1825 CIVIC CENTER DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7113
Country : US
Telephone Number : 312-545-3805
Fax Number :
Provider Business Practice Location Address
First Line : 1825 CIVIC CENTER DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7113
Country : US
Telephone Number : 312-545-3805
Fax Number :
Authorized Official
Title or Position : OWNER/MANAGING PHARMACIST
Name : DR. KARL STEPHEN VILLALUZ
Credential : RPH
Telephone Number : 312-545-3805
Provider Enumeration Date : 02/05/2024
Last Update Date : 04/09/2024

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Directions to “FAMILY MEDICAL PHARMACY, LLC ” Practice Location

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