Active NPI
Stacey Renee Fryman, PHARMACIST
- Pharmacist
- West Union, OH
National Provider Identifier
1124747613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03326979
- Practice address
- 90 Cic Blvd
West Union, OH 45693-8024 - Phone
- (937) 544-8989
- Fax
- (937) 544-5839
- NPI assigned
- Aug 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03326979 | OH | Primary |
Addresses
Primary practice location
90 Cic Blvd
West Union, OH 45693-8024
Mailing address
554 Racers Ranch Road
Manchester, OH 45144
Phone (606) 407-5826
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03326979 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661472000000",
"number": "1124747613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "554 RACERS RANCH ROAD",
"city": "MANCHESTER",
"state": "OH",
"postal_code": "45144",
"telephone_number": "606-407-5826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 CIC BLVD",
"city": "WEST UNION",
"state": "OH",
"postal_code": "456938024",
"telephone_number": "937-544-8989",
"fax_number": "937-544-5839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRYMAN",
"first_name": "STACEY",
"middle_name": "RENEE",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-26",
"last_updated": "2022-08-26",
"certification_date": "2022-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "OH",
"license": "03326979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Union, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.