Provider Demographics
NPI:1972503589
Name:FRIENDSHIP PHARMACY INC
Entity type:Organization
Organization Name:FRIENDSHIP PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUBINO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-624-0440
Mailing Address - Street 1:3300 COTTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-1601
Mailing Address - Country:US
Mailing Address - Phone:215-624-0440
Mailing Address - Fax:215-624-3902
Practice Address - Street 1:3300 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-1601
Practice Address - Country:US
Practice Address - Phone:215-624-0440
Practice Address - Fax:215-624-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPPA10815183500000X
PAPP410815L332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000572820Medicaid
3903146OtherNCPDP
PA000572820Medicaid