Provider Demographics
NPI:1982224234
Name:ROM PHARM, LLC
Entity Type:Organization
Organization Name:ROM PHARM, LLC
Other - Org Name:PARAGON PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-650-6014
Mailing Address - Street 1:10043 SCOTT CIR STE 105
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-3052
Mailing Address - Country:US
Mailing Address - Phone:402-650-6014
Mailing Address - Fax:712-243-2064
Practice Address - Street 1:10043 SCOTT CIR STE 105
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-3052
Practice Address - Country:US
Practice Address - Phone:402-916-5888
Practice Address - Fax:531-466-4279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy