NPI 1033759899

Jerry Walter Frederick, RPH

Practitioner Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist Bloomington, IN

Practice location

Address: 4025 S Old State Road 37, Bloomington, IN 47401-7482
Phone: (812) 824-5205
Fax: (812) 824-5207

Registered specialties

Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist Primary

Pharmacy Service Providers Taxonomy 1835P0018X Licence 26012786A (IN)

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Registry record

NPI: 1033759899
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Jan 2020
Record last updated: 9 Jan 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.