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General NPI Number Information
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NPI Number | 1023007275
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Entity Type | Organization
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Legal Business Name | FRIENDSVILLE PHARMACY UPHOLD LLC
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 248 MAPLE ST
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City | FRIENDSVILLE
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State | MD
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Zip | 21531-2122
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Country | US
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Telephone | 301-746-5881
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Fax | 301-746-5803
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Provider Business Mailing Address
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Address Line | PO BOX 127
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City | FRIENDSVILLE
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State | MD
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Zip | 21531-0127
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Country | US
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Telephone | 301-746-5881
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Fax | 301-746-5803
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Authorized Official
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Title or Position | PHARMD
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Name | JENNIFER UPHOLD
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Credential |
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Telephone | 814-483-4310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | P06419
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License Number State | MD
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