Basic Information
Provider Information
NPI: 1740578962
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRIEMEL
FirstName: ADRIANNE
MiddleName: MAXINE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1201 WHISPERING PINES WAY
Address2:  
City: FITCHBURG
State: WI
PostalCode: 537134328
CountryCode: US
TelephoneNumber: 8063447585
FaxNumber: 6082034544
Practice Location
Address1: 600 HIGHLAND AVE
Address2: MC 2433
City: MADISON
State: WI
PostalCode: 537921530
CountryCode: US
TelephoneNumber: 6086620817
FaxNumber: 6082034544
Other Information
ProviderEnumerationDate: 07/21/2011
LastUpdateDate: 08/31/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X49933TXY Pharmacy Service ProvidersPharmacist 

No ID Information.


Home