Provider Demographics
NPI:1992070403
Name:FRIERSON, EDWARD KEITH
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:KEITH
Last Name:FRIERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 MERRIMON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-3426
Mailing Address - Country:US
Mailing Address - Phone:828-253-4350
Mailing Address - Fax:828-253-1589
Practice Address - Street 1:612 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-3426
Practice Address - Country:US
Practice Address - Phone:828-253-4350
Practice Address - Fax:828-253-1589
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13475183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist