Provider Demographics
NPI:1457892747
Name:ROMIE LANE PHARMACY INC
Entity Type:Organization
Organization Name:ROMIE LANE PHARMACY INC
Other - Org Name:STAR PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:OSTARELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-424-0395
Mailing Address - Street 1:1273 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2185
Mailing Address - Country:US
Mailing Address - Phone:831-424-0395
Mailing Address - Fax:831-424-7949
Practice Address - Street 1:1273 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2185
Practice Address - Country:US
Practice Address - Phone:831-424-0395
Practice Address - Fax:831-424-7949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY546653336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy