Healthcare Provider Details

I. General information

NPI: 1376147546
Provider Name (Legal Business Name): NANCY LEE FRYE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2020
Last Update Date: 11/28/2020
Certification Date: 11/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 ROUND HILL DR.
ORANGE VA
22960
US

IV. Provider business mailing address

720 ROUND HILL DR.
ORANGE VA
22960
US

V. Phone/Fax

Practice location:
  • Phone: 540-672-0872
  • Fax: 540-672-7561
Mailing address:
  • Phone: 540-672-0872
  • Fax: 540-672-7561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202007880
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7880
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: