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NPI Code Detail

MEDICARE: ALEXANDER BOMMARITO RPH

MEDICARE: ALEXANDER BOMMARITO RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist5302021029MI

General Provider Information

NPI Number : 1578831319
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDER BOMMARITO RPH
Provider Business Mailing Address
First Line : 12555 FREELAND
Second Line :
City : FREELAND
State : MI
Zip : 48623
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4989 STATE ST
Second Line :
City : SAGINAW
State : MI
Zip : 48603-3892
Country : US
Telephone Number : 989-791-3088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2011
Last Update Date : 12/08/2011

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Directions to “ ALEXANDER BOMMARITO RPH” Practice Location

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