Provider Demographics
NPI:1841570470
Name:ROMINE, JOHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:ROMINE
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 1:803 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3509
Mailing Address - Country:US
Mailing Address - Phone:316-768-5450
Mailing Address - Fax:
Practice Address - Street 1:803 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3509
Practice Address - Country:US
Practice Address - Phone:316-768-5450
Practice Address - Fax:316-768-5452
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist