Provider Demographics
NPI:1073594792
Name:FRIEDMAN, WARREN DAVID (RPH)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:DAVID
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 E GLENGARY CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3623
Mailing Address - Country:US
Mailing Address - Phone:440-995-1925
Mailing Address - Fax:440-995-1935
Practice Address - Street 1:6770 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2299
Practice Address - Country:US
Practice Address - Phone:440-605-1611
Practice Address - Fax:440-605-1622
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-11693183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist