Provider Demographics
NPI:1710427877
Name:FRIEDMAN, ROBERT THOMAS (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:THOMAS
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 HORSHAM RD UNIT C20
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-0137
Mailing Address - Country:US
Mailing Address - Phone:215-674-5050
Mailing Address - Fax:215-957-8574
Practice Address - Street 1:575 HORSHAM RD UNIT C20
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-0137
Practice Address - Country:US
Practice Address - Phone:215-674-5050
Practice Address - Fax:215-957-8574
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032844R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA14478180002Medicaid