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General NPI Number Information
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NPI Number | 1033418280
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Entity Type | Individual
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Provider Name | RUSSELL FRICK RPH
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Gender | Male
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Dates
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Enumeration Date | 03/26/2011
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Last Update Date | 03/26/2011
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Provider Practice Location Address
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Address Line | 2349 AUGUSTA RD
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4541
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Country | US
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Telephone | 803-794-7935
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Fax | 803-936-9678
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Provider Business Mailing Address
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Address Line | 7 BLUE STONE CT
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City | IRMO
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State | SC
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Zip | 29063-7885
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Country | US
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Telephone | 803-381-7800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 006575
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License Number State | SC
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