Healthcare Provider Details

I. General information

NPI: 1043195068
Provider Name (Legal Business Name): LYDIA FRITSCHE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 FORT ST
BUFFALO WY
82834-1805
US

IV. Provider business mailing address

185 HIGH ST APT 4
BUFFALO WY
82834-1862
US

V. Phone/Fax

Practice location:
  • Phone: 307-684-7003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4618
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: