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General NPI Number Information
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NPI Number | 1356786032
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Entity Type | Individual
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Provider Name | SETH EDWARD FRICKS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 07/12/2016
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Provider Practice Location Address
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Address Line | 4501 66TH ST N
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City | KENNETH CITY
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State | FL
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Zip | 33709-4923
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Country | US
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Telephone | 813-546-5756
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 FORT PICKENS RD APT 122
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City | PENSACOLA BEACH
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State | FL
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Zip | 32561-3973
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Country | US
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Telephone | 850-748-5577
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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 | PS55038
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19311
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License Number State | AL
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