Organization Active NPI

Fricks Pharmacy LLC

  • Community/Retail Pharmacy
  • Pensacola, FL
National Provider Identifier
1497398226
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
FRICKS PHARMACY LLC
Practice address
921 Dr Martin L King Jr Dr Apt C
Pensacola, FL 32501-4090
Phone
(850) 483-0363
NPI assigned
Oct 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Dr. Stephanie Jade Fricks, PHARMDNPI 1316389190
Title
Owner/PDM
Phone
(615) 483-8310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

921 Dr Martin L King Jr Dr Apt C
Pensacola, FL 32501-4090

Mailing address

921 Dr Martin L King Jr Dr Apt C
Pensacola, FL 32501-4090
Phone (850) 665-4657

Other identifiers 1

IdentifierTypeStateIssuer
105468400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200713002630 FL Part B Supplier - Pharmacy 2264854496 Practice locations: Milton, FL
O20200721004348 FL Part B Supplier - Independent Clinical Laboratory 2264854496 Practice locations: Milton, FL

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1497398226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 DR MARTIN L KING JR DR APT C",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325014090",
            "telephone_number": "850-665-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 DR MARTIN L KING JR DR APT C",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325014090",
            "telephone_number": "850-483-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRICKS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-24",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "FRICKS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "JADE",
        "authorized_official_title_or_position": "OWNER/PDM",
        "authorized_official_telephone_number": "615-483-8310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105468400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.