# FRISCO PHARMACY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104802560
- **Authorized official:** MR. ROBERT E. DAVIDSON RPH. (REGISTERED PHARMACIST)
- **Authorized official phone:** (417) 624-6800

## Contact information

- **Practice address:** 2501 S JACKSON AVE, JOPLIN, MO 64804-1941
- **Practice address phone:** (417) 624-6800
- **Mailing address:** 2401 SANDSTONE WAY, JOPLIN, MO 64804-8875
- **Mailing address phone:** (417) 624-6800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 004350 | MO | Yes |

## Other

- **Enumeration date:** 12/19/2005
- **Last updated:** 08/22/2020