Provider Demographics
NPI:1235109588
Name:ROMELHARDT, ANDREW WILLIAM
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WILLIAM
Last Name:ROMELHARDT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 788250
Mailing Address - Street 2:NAVAL HOSPITAL ATTN: PROFESSIONAL AFFAIRS MAGTFTC MCAGC
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92278-8250
Mailing Address - Country:US
Mailing Address - Phone:760-830-2670
Mailing Address - Fax:760-830-2131
Practice Address - Street 1:NAVAL HOSPITAL
Practice Address - Street 2:ATTN PROFESSIONAL AFFAIRS MAGTFTC MCAGCC
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92278-8250
Practice Address - Country:US
Practice Address - Phone:760-830-2670
Practice Address - Fax:760-830-2131
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist