MEDICARE: ELAINE C ROMERO PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP00006997	NM
2	183500000X	Pharmacist	19235	CO

General Provider Information

NPI Number	:	1265621379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE C ROMERO PHARMD

Provider Business Mailing Address
First Line	:	1015 S TAFT HILL RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4240
Country	:	US
Telephone Number	:	970-221-4940
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 S TAFT HILL RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4240
Country	:	US
Telephone Number	:	970-221-4940
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2007
Last Update Date	:	04/29/2013

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