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NPI Code Detail

MEDICARE: RODERICK ROMES JR. PHARMD

MEDICARE:   RODERICK  ROMES JR. PHARMD
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
1183500000XPharmacistPD12384AR

General Provider Information

NPI Number : 1396383865
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODERICK ROMES JR. PHARMD
Provider Business Mailing Address
First Line : 5312 CYPRESS DR
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72076-9465
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 103 GREGORY PL
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72076-3211
Country : US
Telephone Number : 501-985-0822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2019
Last Update Date : 12/16/2019

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Directions to “ RODERICK ROMES JR. PHARMD” Practice Location

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