Frederick Nji Chomilo, PHARMD
Individual provider Active NPI Pharmacotherapy Pharmacist · Virginia, MN
NPI 1710243472 · NPPES record last updated Apr 6, 2012
Key facts
- NPI
- 1710243472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacotherapy Pharmacist 1835P1200X
- License
- 115988 (MN)
- Practice address
- 1401 S 12TH Ave
Virginia, MN 55792-3247 - Phone
- (218) 749-4014
- Fax
- (218) 749-1107
- NPI assigned
- Apr 6, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115988 | MN | MD | Pharmacotherapy Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 115988 | MN | Yes |
Addresses
Primary practice location
1401 S 12TH Ave
Virginia, MN 55792-3247
Mailing address
1401 S 12TH Ave
Virginia, MN 55792-3247
Phone (218) 749-4014
Other providers in Virginia, MN
- Sarah Sue Chaffee
- Jodi A Chaffin
- Cassandra Chambers
- Mary R Champa
- Charles a Tietz MD Facog LTD
- Christian Neurology Associates of Minnesota, PA
- Christine Ann Christie
- Chrysalis Wellness, PLC
- Allee Marie Chyrklund
- Frederick Cina
All providers in Virginia, MN · Pharmacotherapy Pharmacist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2012. 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.