Provider Demographics
NPI:1578686077
Name:FRIENDSHIP PHARMACY INC
Entity Type:Organization
Organization Name:FRIENDSHIP PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPH INCHARGED OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MBAKEM
Authorized Official - Last Name:AKAH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:973-484-0643
Mailing Address - Street 1:212 BLOOMFIELD AVE
Mailing Address - Street 2:FRIENDSHIP PHARMACY INC
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104
Mailing Address - Country:US
Mailing Address - Phone:973-484-0643
Mailing Address - Fax:973-484-0751
Practice Address - Street 1:212 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104
Practice Address - Country:US
Practice Address - Phone:973-484-0643
Practice Address - Fax:973-484-0751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28S005176003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3136694OtherNABP
NJ6667007Medicaid
NJ6667007Medicaid