Healthcare Provider Details

I. General information

NPI: 1598416463
Provider Name (Legal Business Name): LAVINIA SALAMA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2022
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 E 17TH ST
CHEYENNE WY
82001-4714
US

IV. Provider business mailing address

820 E 17TH ST
CHEYENNE WY
82001-4714
US

V. Phone/Fax

Practice location:
  • Phone: 307-632-2434
  • Fax:
Mailing address:
  • Phone: 307-632-2434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4392
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: