Provider Demographics
NPI:1699198044
Name:ROMERO, JOSE (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:ROMERO
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 W VALENCIA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-6021
Mailing Address - Country:US
Mailing Address - Phone:520-573-3167
Mailing Address - Fax:520-573-0317
Practice Address - Street 1:1650 W VALENCIA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-6021
Practice Address - Country:US
Practice Address - Phone:520-573-3167
Practice Address - Fax:520-573-0317
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist