Organization
PHAMILY PHARMACY LLC
Active
Organization
PHAMILY PHARMACY LLC
Active
Other names
Phamily Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DALE PHAM RPH (OWNER/PIC/AO)
(321) 945-0410
Entity
Organization
Contact information
Practice address
407 W OAK ST, KISSIMMEE, FL 34741-4931
(407) 201-4348
(407) 201-4737
Mailing address
407 W OAK ST, KISSIMMEE, FL 34741-4931
(407) 201-4348
(407) 201-4737
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH30102
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019295600
—
FL
01
—
2159920
PK
—
Enumeration date
05/03/2016
Last updated
06/02/2021
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