# FAMILY LTC PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAMILY PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568495463
- **Authorized official:** PAUL ALEXANDER (PIC)
- **Authorized official phone:** (276) 632-0816

## Contact information

- **Practice address:** 1049 BROOKDALE ST, STE B, MARTINSVILLE, VA 24112-3971
- **Practice address phone:** (276) 632-0816
- **Practice address fax:** (276) 632-0871
- **Mailing address:** PO BOX 4589, MARTINSVILLE, VA 24115-4589

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 201004222 | VA | Yes |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 10/27/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2105973 | PK | — |