MEDICARE: MR. HARVEY R ROME PHARMACIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03110044	OH

General Provider Information

NPI Number	:	1336413111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HARVEY R ROME PHARMACIST

Provider Business Mailing Address
First Line	:	3340 DORR STREET
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607
Country	:	US
Telephone Number	:	419-531-2836
Fax Number	:

Provider Business Practice Location Address
First Line	:	3340 DORR ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-2717
Country	:	US
Telephone Number	:	419-531-2836
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2012
Last Update Date	:	02/27/2012

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