Provider Demographics
NPI:1346282910
Name:FRICK, CANDACE CROMER (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:CROMER
Last Name:FRICK
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 1:15 EDGEWATER CT
Mailing Address - Street 2:
Mailing Address - City:PROSPERITY
Mailing Address - State:SC
Mailing Address - Zip Code:29127-9340
Mailing Address - Country:US
Mailing Address - Phone:803-364-3295
Mailing Address - Fax:
Practice Address - Street 1:1310 WILSON RD
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-3048
Practice Address - Country:US
Practice Address - Phone:803-276-0990
Practice Address - Fax:803-276-4276
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC009697183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist