Provider Demographics
NPI:1740616531
Name:FRIEND, EVELYN SUE (RPH)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:SUE
Last Name:FRIEND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 BERGEN PKWY
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9522
Mailing Address - Country:US
Mailing Address - Phone:303-674-8246
Mailing Address - Fax:303-670-6840
Practice Address - Street 1:1173 BERGEN PKWY
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-9522
Practice Address - Country:US
Practice Address - Phone:303-674-8246
Practice Address - Fax:303-670-6840
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist