Individual provider Active NPI

Ira Gary Fried, RPH

  • Pharmacist
  • Feasterville Trevose, PA
National Provider Identifier
1205187960
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP028967L Issued in PA
Practice address
2 E Street Rd
Feasterville Trevose, PA 19053-7603
Phone
(215) 364-8770
Fax
(215) 364-1792
NPI assigned
Sep 20, 2012
Last updated
Sep 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP028967L PA Primary

Addresses

Primary practice location

2 E Street Rd
Feasterville Trevose, PA 19053-7603

Mailing address

666 Artwood Dr
Philadelphia, PA 19115-2807
Phone (215) 673-1695

Other identifiers 1

IdentifierTypeStateIssuer
RP028967LOtherPAPENNA STATE BOARD OF PHARMACY

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP028967LPAMDPharmacist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1205187960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 ARTWOOD DR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152807",
            "telephone_number": "215-673-1695",
            "fax_number": "215-364-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E STREET RD",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190537603",
            "telephone_number": "215-364-8770",
            "fax_number": "215-364-1792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIED",
        "first_name": "IRA",
        "middle_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP028967L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNA STATE BOARD OF PHARMACY",
            "identifier": "RP028967L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Feasterville Trevose, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.