Organization
FAMILY PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STANLEY D DEWEESE RPH (PRESIDENT)
(812) 735-4444
Entity
Organization
Contact information
Practice address
508 W 11TH ST, BICKNELL, IN 47512-9626
(812) 735-4444
(812) 735-3017
Mailing address
508 W 11TH ST, BICKNELL, IN 47512-9626
(812) 735-4444
(812) 735-3017
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
60002628A
IN
332BN1400X
Nursing Facility Supplies (DME)
60002628A
IN
333600000X
Pharmacy
Primary
60002628A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097231
ANTHEM BLUE DME NUMBER
IN
01
—
000000216711
ANTHEM BLUE ORTH & PROS
IN
01
—
1519454
NABP
IN
Enumeration date
12/13/2006
Last updated
04/20/2008
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