Healthcare Provider Details

I. General information

NPI: 1306937917
Provider Name (Legal Business Name): DAVID FOLMAR RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 MEDGROUP/SGSAP UNIT 5071 BLDG 4408
APO AP
96326
JP

IV. Provider business mailing address

374 MEDGROUP SGSAP UNIT 5071 BLDG 4408
APO AP
96326
JP

V. Phone/Fax

Practice location:
  • Phone: 315-225-3510
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13491
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: