Organization Name: | FRYS |
NPI Number: | 1194153148 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYLE GREEN TRONE (PHARMACIST) |
Mailing Address: | 500 S 99th Ave Tolleson |
State: | AZ US |
Postal Code: | 853539700 |
Phone Number: | 5204580997 |
Fax Number: | 5204585849 |
NPI Enumeration Date: | 10/29/2013 |
NPI Last Update Date: | 10/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 302R00000X |
License Number: | S020208 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Health Maintenance Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |