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General NPI Number Information
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NPI Number | 1124091400
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Entity Type | Individual
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Provider Name | LISA G BRUMMEL RPH
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 09/02/2007
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Provider Practice Location Address
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Address Line | 6 W MAIN ST
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City | FREMONT
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State | MI
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Zip | 49412-1136
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Country | US
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Telephone | 231-924-2720
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Fax | 231-924-1281
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Provider Business Mailing Address
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Address Line | 5886 S WARNER AVE
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City | FREMONT
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State | MI
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Zip | 49412-9275
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Country | US
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Telephone |
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Fax |
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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 | 5302026460
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License Number State | MI
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