Provider Demographics
NPI:1346552361
Name:FRICK, TERRI W (BS RPH)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:W
Last Name:FRICK
Suffix:
Gender:F
Credentials:BS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 CHAPIN RD
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-8874
Mailing Address - Country:US
Mailing Address - Phone:803-345-1175
Mailing Address - Fax:803-932-7706
Practice Address - Street 1:1401 CHAPIN RD
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-8874
Practice Address - Country:US
Practice Address - Phone:803-345-1175
Practice Address - Fax:803-932-7706
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC007140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist