=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346112992
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROMAN HEALTH PHARMACY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2025
-----------------------------------------------------
Last Update Date | 09/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1560-1564 BARCLAY BOULEVARD
-----------------------------------------------------
City | BUFFALO GROVE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-798-8686
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PHARMACY LICENSING 3602 QUANTUM BLVD.
-----------------------------------------------------
City | BOYNTON BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33426
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-344-3894
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER, PHARMACY LICENSING
-----------------------------------------------------
Name | KIMBERLY ANNE SORRENTINO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 470-344-3894
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------