MEDICARE: FRIENDLY FAMILY 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	183500000X	Pharmacist	15610	NC

General Provider Information

NPI Number	:	1245537059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDLY FAMILY PHARMACY

Provider Business Mailing Address
First Line	:	6413 ALBEMARLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-3815
Country	:	US
Telephone Number	:	704-806-3782
Fax Number	:

Provider Business Practice Location Address
First Line	:	6413 ALBEMARLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-3815
Country	:	US
Telephone Number	:	704-806-3782
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DIEM NGUYEN
Credential	:	RPH
Telephone Number	:	704-806-3782

Provider Enumeration Date	:	02/15/2011
Last Update Date	:	02/15/2011

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