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General NPI Number Information
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NPI Number | 1609471796
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Entity Type | Individual
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Provider Name | VIRGIL MARTIN SCHROM IV PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 290 W CARLETON RD
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City | HILLSDALE
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State | MI
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Zip | 49242-5034
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Country | US
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Telephone | 517-439-9409
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Fax |
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Provider Business Mailing Address
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Address Line | 39 CARRIAGE PARK
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City | HILLSDALE
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State | MI
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Zip | 49242-1449
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Country | US
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Telephone | 517-610-0955
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 5302412707
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License Number State | MI
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