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General NPI Number Information
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NPI Number | 1083854525
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Entity Type | Individual
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Provider Name | FREDERICK B JANSSEN RPH, MBA
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Gender | Male
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Dates
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Enumeration Date | 02/24/2009
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 21 W CLARKE AVE
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City | MILFORD
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State | DE
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Zip | 19963-1840
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Country | US
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Telephone | 302-430-5563
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Fax | 302-430-5514
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Provider Business Mailing Address
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Address Line | 21 W CLARKE AVE
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City | MILFORD
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State | DE
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Zip | 19963-1840
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Country | US
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Telephone | 302-430-5563
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Fax | 302-430-5514
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | A1-0002110
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License Number State | DE
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