Healthcare Provider Details

I. General information

NPI: 1114359783
Provider Name (Legal Business Name): FRITZ'S PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 KANAWHA AVE
RAINELLE WV
25962-1045
US

IV. Provider business mailing address

499 KANAWHA AVE
RAINELLE WV
25962-1045
US

V. Phone/Fax

Practice location:
  • Phone: 304-438-8500
  • Fax: 304-438-8501
Mailing address:
  • Phone: 304-438-8500
  • Fax: 304-438-8501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: JANICE GLASSER
Title or Position: OWNER
Credential:
Phone: 304-645-1890