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General NPI Number Information
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NPI Number | 1124362470
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Entity Type | Organization
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Legal Business Name | FRIENDSHIP, LLC
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 03/01/2013
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Provider Practice Location Address
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Address Line | 5532 HWY 15 SUITE 1
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City | ECRU
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State | MS
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Zip | 38841
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Country | US
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Telephone | 662-488-0317
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Fax |
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Provider Business Mailing Address
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Address Line | 5532 HWY 15 SUITE 1
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City | ECRU
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State | MS
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Zip | 38841
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Country | US
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Telephone | 662-488-0317
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ANDREW NOWLIN
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Credential |
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Telephone | 662-489-5677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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