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NPI Code Detail

MEDICARE: JAMES MAURITZ GLOMBOWSKI RPH

MEDICARE:   JAMES MAURITZ GLOMBOWSKI  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5302031273MI

General Provider Information

NPI Number : 1295518843
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MAURITZ GLOMBOWSKI RPH
Provider Business Mailing Address
First Line : 10443 E MUNRO LAKE DR
Second Line :
City : LEVERING
State : MI
Zip : 49755-8504
Country : US
Telephone Number : 989-330-7840
Fax Number :
Provider Business Practice Location Address
First Line : 3944 S STRAITS HWY
Second Line :
City : INDIAN RIVER
State : MI
Zip : 49749-5135
Country : US
Telephone Number : 231-238-2499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2023
Last Update Date : 08/17/2023

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Directions to “ JAMES MAURITZ GLOMBOWSKI RPH” Practice Location

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