Provider Demographics
NPI:1598155582
Name:FRIDAY, TAMARA (RPH)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:FRIDAY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67505-1123
Mailing Address - Country:US
Mailing Address - Phone:620-663-2258
Mailing Address - Fax:620-663-8340
Practice Address - Street 1:503 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67505-1123
Practice Address - Country:US
Practice Address - Phone:620-663-2258
Practice Address - Fax:620-663-8340
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-11998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist