Provider Demographics
NPI:1053062406
Name:ROMAN HEALTH PHARMACY LLC
Entity Type:Organization
Organization Name:ROMAN HEALTH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:REITANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-798-8686
Mailing Address - Street 1:3602 QUANTUM BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:805 W CARRIER PKWY STE 240
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-1089
Practice Address - Country:US
Practice Address - Phone:888-798-8686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROMAN HEALTH VENTURES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No333600000XSuppliersPharmacy