Provider Demographics
NPI:1437885944
Name:FRIES, JAMIE (PHARMD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:FRIES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SCHOOLHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-9767
Mailing Address - Country:US
Mailing Address - Phone:610-301-9017
Mailing Address - Fax:
Practice Address - Street 1:2030 FRUITVILLE PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3998
Practice Address - Country:US
Practice Address - Phone:717-581-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP456866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP456866OtherPENNSYLVANIA BOARD OF PHARMACY