Provider Demographics
NPI:1417404781
Name:LOMRI, TAHAR (RPH)
Entity Type:Individual
Prefix:
First Name:TAHAR
Middle Name:
Last Name:LOMRI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10832 BEDFORDTOWN DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8059
Mailing Address - Country:US
Mailing Address - Phone:919-803-0917
Mailing Address - Fax:
Practice Address - Street 1:1825 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4925
Practice Address - Country:US
Practice Address - Phone:252-535-4681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist