Provider Demographics
NPI:1700063856
Name:LOMBARDO, DAMIEN J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAMIEN
Middle Name:J
Last Name:LOMBARDO
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 1:327 WOODALE DR APT 92
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-7219
Mailing Address - Country:US
Mailing Address - Phone:318-376-7453
Mailing Address - Fax:
Practice Address - Street 1:327 WOODALE DR APT 92
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-7219
Practice Address - Country:US
Practice Address - Phone:318-376-7453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist