Healthcare Provider Details

I. General information

NPI: 1902801202
Provider Name (Legal Business Name): JEFFREY F. TROMBLEY R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10725 HARRISON
ROMULUS MI
48174-2647
US

IV. Provider business mailing address

10725 HARRISON
ROMULUS MI
48174-2647
US

V. Phone/Fax

Practice location:
  • Phone: 734-784-2042
  • Fax: 734-946-3152
Mailing address:
  • Phone: 734-784-2042
  • Fax: 734-946-3152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302024486
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: