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NPI Code Detail

MEDICARE: CLIFFORD FRYAR PHARM D

MEDICARE: CLIFFORD FRYAR PHARM D
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
11835P2201XAmbulatory Care Pharmacist020105KY

General Provider Information

NPI Number : 1699373399
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLIFFORD FRYAR PHARM D
Provider Business Mailing Address
First Line : 9001 US HIGHWAY 42
Second Line :
City : UNION
State : KY
Zip : 41091-7191
Country : US
Telephone Number : 859-334-9420
Fax Number :
Provider Business Practice Location Address
First Line : 9001 US HIGHWAY 42
Second Line :
City : UNION
State : KY
Zip : 41091-7191
Country : US
Telephone Number : 859-334-9420
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2020
Last Update Date : 10/14/2020

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Directions to “ CLIFFORD FRYAR PHARM D” Practice Location

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