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General NPI Number Information
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NPI Number | 1457892747
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Entity Type | Organization
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Legal Business Name | ROMIE LANE PHARMACY INC
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 1273 S MAIN ST
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City | SALINAS
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State | CA
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Zip | 93901-2185
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Country | US
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Telephone | 831-424-0395
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Fax | 831-424-7949
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Provider Business Mailing Address
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Address Line | 1273 S MAIN ST
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City | SALINAS
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State | CA
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Zip | 93901-2185
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Country | US
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Telephone | 831-424-0395
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Fax | 831-424-7949
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Authorized Official
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Title or Position | OWNER/PIC
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Name | DR. RUSSELL JOHN OSTARELLO
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Credential |
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Telephone | 831-424-0395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY54665
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License Number State | CA
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