Provider Demographics
NPI:1639474562
Name:FRITZ'S PHARMACY II
Entity Type:Organization
Organization Name:FRITZ'S PHARMACY II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GLASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-645-1890
Mailing Address - Street 1:1318 JEFFERSON STREET NORTH
Mailing Address - Street 2:SUITE #2
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-1063
Mailing Address - Country:US
Mailing Address - Phone:304-645-7447
Mailing Address - Fax:
Practice Address - Street 1:1318 JEFFERSON STREET NORTH
Practice Address - Street 2:SUITE #2
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-1063
Practice Address - Country:US
Practice Address - Phone:304-645-7447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV183500000X261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center