Healthcare Provider Details

I. General information

NPI: 1609485085
Provider Name (Legal Business Name): ROMAN HURST PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 SQUALICUM PKWY
BELLINGHAM WA
98225-1851
US

IV. Provider business mailing address

2230 CORNERSTONE LN UNIT 312
BELLINGHAM WA
98226-6006
US

V. Phone/Fax

Practice location:
  • Phone: 360-734-5400
  • Fax:
Mailing address:
  • Phone: 360-640-0669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH61072488
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: