Provider Demographics
NPI:1790202695
Name:FRIENDSHIP PHARMACY, INC.
Entity Type:Organization
Organization Name:FRIENDSHIP PHARMACY, INC.
Other - Org Name:FRIENDSHIP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-777-4044
Mailing Address - Street 1:327 HERSHBERGER RD.
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012
Mailing Address - Country:US
Mailing Address - Phone:540-265-2129
Mailing Address - Fax:540-265-2154
Practice Address - Street 1:327 HERSHBERGER RD.
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012
Practice Address - Country:US
Practice Address - Phone:540-265-2152
Practice Address - Fax:540-777-6865
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRIENDSHIP PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-23
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201002863336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4848050OtherNCPDP