Healthcare Provider Details

I. General information

NPI: 1174996276
Provider Name (Legal Business Name): BENJAMIN PETER VROMAN PHARM.D., BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2015
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 S MAIN ST
MEADVILLE PA
16335-3036
US

IV. Provider business mailing address

1305 S MAIN ST
MEADVILLE PA
16335-3036
US

V. Phone/Fax

Practice location:
  • Phone: 855-693-2286
  • Fax: 888-704-4877
Mailing address:
  • Phone: 855-693-2286
  • Fax: 888-704-4877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP0013405
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03442931
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP445686
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRP445686
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: