Provider Demographics
NPI:1306038344
Name:FRIENDSHIP MEDICAL CENTER, PA
Entity Type:Organization
Organization Name:FRIENDSHIP MEDICAL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:L
Authorized Official - Last Name:TROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-851-6260
Mailing Address - Street 1:400 ASHVILLE AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6134
Mailing Address - Country:US
Mailing Address - Phone:919-851-6260
Mailing Address - Fax:919-851-6261
Practice Address - Street 1:400 ASHVILLE AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6134
Practice Address - Country:US
Practice Address - Phone:919-851-6260
Practice Address - Fax:919-851-6261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2004-01443207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907783Medicaid
NC5907783Medicaid
NC2035101FMedicare PIN