Provider Demographics
NPI:1598537185
Name:FRY, HAILEY MORGAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:MORGAN
Last Name:FRY
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 1:4303 TERRACE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-4934
Mailing Address - Country:US
Mailing Address - Phone:717-712-2530
Mailing Address - Fax:
Practice Address - Street 1:1020 N DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-4334
Practice Address - Country:US
Practice Address - Phone:267-324-5347
Practice Address - Fax:267-324-5418
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP458118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist