Provider Demographics
NPI:1235643610
Name:FRY, LAURA (PHARMD RPH)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:FRY
Suffix:
Gender:F
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3772 COVE RD
Mailing Address - Street 2:
Mailing Address - City:ACCIDENT
Mailing Address - State:MD
Mailing Address - Zip Code:21520-2045
Mailing Address - Country:US
Mailing Address - Phone:724-747-8488
Mailing Address - Fax:
Practice Address - Street 1:101 BISHOP MURPHY DR
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-1329
Practice Address - Country:US
Practice Address - Phone:301-689-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist