Healthcare Provider Details

I. General information

NPI: 1386758209
Provider Name (Legal Business Name): ELIZABETH ANN ROMAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 LANCASTER DR
BROOKLYN HEIGHTS OH
44131-1832
US

IV. Provider business mailing address

6841 BERESFORD AVE
PARMA HEIGHTS OH
44130-3750
US

V. Phone/Fax

Practice location:
  • Phone: 216-635-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-22801
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: