Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JERRY WALTER FREDERICK, RPH
ActivePharmacist Clinician (PhC) · BLOOMINGTON, IN
Registration Details
- NPI Number
- 1033759899
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 9, 2020 (6.2998377343538 yrs)
- Last Updated
- Jan 9, 2020
- License
-
26012786A (IN)
Practice Information
- Address
-
4025 S OLD STATE ROAD 37BLOOMINGTON, IN, 474017482Browse IN providers · Browse ZIP 47401
- Phone
- 8128245205
- Fax
- 8128245207
- Primary Specialty
-
Pharmacist Clinician (PhC)
1835P0018X
Other Pharmacist Clinician (PhC) Providers in BLOOMINGTON, IN
| Name | Credential | NPI |
|---|---|---|
| BRENT WOLFORD | RPH | 1538496914 |
| JENNIFER GALE REITER | PHARM.D. | 1912217357 |
| DR. ELISE ANNE MCCUISTON | PHARMD | 1235497488 |
| JAYNA MARLENE BLAND | PHARMD | 1457906844 |
| DEREK BRENT FIELDS | — | 1326684267 |
| SAVANNA SPICE | — | 1073130373 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.