Strom, Jonathan William

Strom, Jonathan William is an individual health care provider with primary practice located at 744 South Webster Ave , Green Bay WI 54307-3400. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Strom, Jonathan William can be contacted via phone (920) 431-5696.

Contact Information

Primary practice address
744 South Webster Ave Green Bay WI 54307-3400
Fax: (920) 431-5677
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 12561040 Wisconsin

Profile Details

NPI number 1063423200
LBN Legal business name Strom, Jonathan William
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Jul 8th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1063423200 NPPES
Other 5124689 NCPDP
MEDICAID 33233700 NCPDP

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