Provider Demographics
NPI:1184127219
Name:ROMIG, AMANDA L (RPH)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:ROMIG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-2718
Mailing Address - Country:US
Mailing Address - Phone:814-355-3225
Mailing Address - Fax:
Practice Address - Street 1:105 N ALLEGHENY ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1626
Practice Address - Country:US
Practice Address - Phone:814-355-3225
Practice Address - Fax:814-355-8547
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040497L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty