Lisa G Brummel, RPH
Individual provider Active NPI Pharmacist · Fremont, MI
NPI 1124091400 · NPPES record last updated Sep 2, 2007
Key facts
- NPI
- 1124091400
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302026460 (MI)
- Practice address
- 6 W Main St
Fremont, MI 49412-1136 - Phone
- (231) 924-2720
- Fax
- (231) 924-1281
- NPI assigned
- Feb 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302026460 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cisler Pharmacy Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302026460 | MI | Yes |
Addresses
Primary practice location
6 W Main St
Fremont, MI 49412-1136
Mailing address
5886 S Warner Ave
Fremont, MI 49412-9275
Other providers in Fremont, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.