Organization
FAMILY LTC PHARMACY INC
Active
Other names
FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL ALEXANDER (PIC)
(276) 632-0816
Entity
Organization
Contact information
Practice address
1049 BROOKDALE ST, STE B, MARTINSVILLE, VA 24112-3971
(276) 632-0816
(276) 632-0871
Mailing address
PO BOX 4589, MARTINSVILLE, VA 24115-4589
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
201004222
VA
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2105973
PK
—
Enumeration date
07/07/2006
Last updated
10/27/2016
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