MEDICARE: MR. JEFFREY F. TROMBLEY R.PH.

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
1	183500000X	Pharmacist	5302024486	MI

General Provider Information

NPI Number	:	1902801202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY F. TROMBLEY R.PH.

Provider Business Mailing Address
First Line	:	10725 HARRISON
Second Line	:
City	:	ROMULUS
State	:	MI
Zip	:	48174-2647
Country	:	US
Telephone Number	:	734-784-2042
Fax Number	:	734-946-3152

Provider Business Practice Location Address
First Line	:	10725 HARRISON
Second Line	:
City	:	ROMULUS
State	:	MI
Zip	:	48174-2647
Country	:	US
Telephone Number	:	734-784-2042
Fax Number	:	734-946-3152

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	02/25/2008

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