Provider Demographics
NPI:1053718924
Name:FAMILY PHARMACY, INC
Entity type:Organization
Organization Name:FAMILY PHARMACY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREEM
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAMDY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:703-762-6220
Mailing Address - Street 1:10132 COLVIN RUN RD STE D
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1840
Mailing Address - Country:US
Mailing Address - Phone:703-762-6220
Mailing Address - Fax:571-316-1385
Practice Address - Street 1:10721 MAIN ST
Practice Address - Street 2:107
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6914
Practice Address - Country:US
Practice Address - Phone:571-340-3355
Practice Address - Fax:571-316-1545
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY PHARMACY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201004618333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0201004618OtherVIRGINIA BOARD OF PHARMACY