Provider Demographics
NPI:1932105350
Name:FRICK REXALL DRUGS, INC.
Entity Type:Organization
Organization Name:FRICK REXALL DRUGS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CYRIL
Authorized Official - Middle Name:B
Authorized Official - Last Name:FRICK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:360-683-9536
Mailing Address - Street 1:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-0667
Mailing Address - Country:US
Mailing Address - Phone:360-683-9536
Mailing Address - Fax:360-683-0911
Practice Address - Street 1:609 SEQUIM VILLAGE CENTER
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382
Practice Address - Country:US
Practice Address - Phone:360-683-9536
Practice Address - Fax:360-683-0911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA332B00000X, 332BP3500X
WA4908236333600000X
WA8043335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered333600000XSuppliersPharmacy
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6028500Medicaid
WA4908236OtherNABP
WA4908236OtherNABP