Provider Demographics
NPI:1518281534
Name:FRIENDLY PHARMACY
Entity Type:Organization
Organization Name:FRIENDLY PHARMACY
Other - Org Name:FRIENDLY PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FOLORUNSO
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINYELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-322-4346
Mailing Address - Street 1:PO BOX 88095
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77288-0095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3533 S DAIRY ASHFORD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5535
Practice Address - Country:US
Practice Address - Phone:832-351-2000
Practice Address - Fax:832-351-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-19
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX268403336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2124236OtherPK