Provider Demographics
NPI:1871079426
Name:ANGIER FAMILY PHARMACY, LLC
Entity type:Organization
Organization Name:ANGIER FAMILY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:LISCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:919-639-0155
Mailing Address - Street 1:50 E DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:ANGIER
Mailing Address - State:NC
Mailing Address - Zip Code:27501-6017
Mailing Address - Country:US
Mailing Address - Phone:919-639-0155
Mailing Address - Fax:919-639-2755
Practice Address - Street 1:50 E DEPOT ST
Practice Address - Street 2:
Practice Address - City:ANGIER
Practice Address - State:NC
Practice Address - Zip Code:27501-6017
Practice Address - Country:US
Practice Address - Phone:919-639-0155
Practice Address - Fax:919-639-2755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13790333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy