Frederick, Jerry Walter

Frederick, Jerry Walter is an individual health care provider with primary practice located at 4025 S Old State Road 37 , Bloomington IN 47401-7482. He recently has only one registered license in Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, which is considered as his primary health care specialty. Frederick, Jerry Walter can be contacted via phone (812) 824-5205.

Contact Information

Primary practice address
4025 S Old State Road 37 Bloomington IN 47401-7482
Phone: (812) 824-5205
Fax: (812) 824-5207
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 26012786A Indiana

Profile Details

NPI number 1033759899
LBN Legal business name Frederick, Jerry Walter
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2020
Last updated Jan 9th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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