MEDICARE: FRIENDLY PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1205432465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDLY PHARMACY

Provider Business Mailing Address
First Line	:	3712 LAWNDALE DR STE G
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-3066
Country	:	US
Telephone Number	:	336-790-7343
Fax Number	:	336-763-0693

Provider Business Practice Location Address
First Line	:	3712 LAWNDALE DR STE G
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-3066
Country	:	US
Telephone Number	:	336-790-7343
Fax Number	:	336-763-0693

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES BRAXTON
Credential	:	PHARMD
Telephone Number	:	336-944-1365

Provider Enumeration Date	:	12/11/2020
Last Update Date	:	12/11/2020

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Directions to “FRIENDLY PHARMACY ” Practice Location

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