Provider Demographics
NPI:1902801202
Name:TROMBLEY, JEFFREY F (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:F
Last Name:TROMBLEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10725 HARRISON
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-2647
Mailing Address - Country:US
Mailing Address - Phone:734-784-2042
Mailing Address - Fax:734-946-3152
Practice Address - Street 1:10725 HARRISON
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-2647
Practice Address - Country:US
Practice Address - Phone:734-784-2042
Practice Address - Fax:734-946-3152
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist