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General NPI Number Information
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NPI Number | 1730256157
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Entity Type | Individual
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Provider Name | ANTHONY JOSEPH DEROMEDI PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 621 RICHARDS ST
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City | THERMOPOLIS
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State | WY
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Zip | 82443-3041
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Country | US
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Telephone | 307-864-2369
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Fax | 307-864-9202
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Provider Business Mailing Address
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Address Line | 209 WEST MAIN
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City | KIRBY
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State | WY
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Zip | 82430
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Country | US
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Telephone | 307-760-5192
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Fax | 307-864-9202
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3121
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License Number State | WY
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