Healthcare Provider Details

I. General information

NPI: 1407069115
Provider Name (Legal Business Name): FRITZS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 RAILROAD AVE
ALDERSON WV
24910-7000
US

IV. Provider business mailing address

PO BOX 1063
LEWISBURG WV
24901-4063
US

V. Phone/Fax

Practice location:
  • Phone: 304-445-2956
  • Fax: 304-445-2417
Mailing address:
  • Phone: 304-645-1890
  • Fax: 866-645-0321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberSP0552467
License Number StateWV

VIII. Authorized Official

Name: NORMAN GLASSER
Title or Position: TREASURER
Credential:
Phone: 304-645-1890