Healthcare Provider Details

I. General information

NPI: 1861420119
Provider Name (Legal Business Name): JEAN FRIES RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 PENN AVE
SINKING SPRING PA
19608-9708
US

IV. Provider business mailing address

7 SCHOOLHOUSE LN
FLEETWOOD PA
19522-9767
US

V. Phone/Fax

Practice location:
  • Phone: 610-678-6610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP035461L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: