Provider Demographics
NPI:1699107177
Name:HROMIKA, ALYSSA JO FABIAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:JO FABIAN
Last Name:HROMIKA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ALYSSA
Other - Middle Name:JO
Other - Last Name:FABIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:1260 AJIJAAK AVE
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8330
Mailing Address - Country:US
Mailing Address - Phone:231-242-1700
Mailing Address - Fax:231-242-1717
Practice Address - Street 1:1301 N US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-9307
Practice Address - Country:US
Practice Address - Phone:231-348-7510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212287183500000X
MI53020399841835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist