Provider Demographics
NPI:1073109211
Name:ROMNEY, ADAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:ROMNEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7571 S 3800 W
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-4319
Mailing Address - Country:US
Mailing Address - Phone:801-282-5674
Mailing Address - Fax:801-282-5678
Practice Address - Street 1:7571 S 3800 W
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-4319
Practice Address - Country:US
Practice Address - Phone:801-282-5674
Practice Address - Fax:801-282-5678
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4805347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist