Provider Demographics
NPI:1437702156
Name:ROMAN HEALTH PHARMACY, LLC
Entity Type:Organization
Organization Name:ROMAN HEALTH PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFAYETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-490-2407
Mailing Address - Street 1:900 BROADWAY STE 706
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-1230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2331 W ROYAL PALM RD STE A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4940
Practice Address - Country:US
Practice Address - Phone:888-798-8686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy