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General NPI Number Information
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NPI Number | 1497398226
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Entity Type | Organization
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Legal Business Name | FRICKS PHARMACY LLC
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 921 DR MARTIN L KING JR DR APT C
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City | PENSACOLA
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State | FL
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Zip | 32501-4090
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Country | US
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Telephone | 850-483-0363
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Fax |
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Provider Business Mailing Address
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Address Line | 921 DR MARTIN L KING JR DR APT C
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City | PENSACOLA
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State | FL
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Zip | 32501-4090
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Country | US
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Telephone | 850-665-4657
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Fax |
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Authorized Official
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Title or Position | OWNER/PDM
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Name | DR. STEPHANIE JADE FRICKS
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Credential | PHARMD
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Telephone | 615-483-8310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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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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