Healthcare Provider Details

I. General information

NPI: 1184851768
Provider Name (Legal Business Name): CAMYN HERJE SCHROCK RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 06/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VILSECK HEALTH CLINIC ROSE BARROCKS BLDG 250
APO AE
09112
US

IV. Provider business mailing address

CMR 411 BOX 2753
APO AE
09112-4028
US

V. Phone/Fax

Practice location:
  • Phone: 999-476-2004
  • Fax:
Mailing address:
  • Phone: 491510121224454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15583
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number42359
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: