Provider Demographics
NPI:1932526456
Name:ROMA MARKETING
Entity Type:Organization
Organization Name:ROMA MARKETING
Other - Org Name:CHINO MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:SANDRA
Authorized Official - Last Name:CODESAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:562-472-5743
Mailing Address - Street 1:12422 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2603
Mailing Address - Country:US
Mailing Address - Phone:909-464-1500
Mailing Address - Fax:
Practice Address - Street 1:12422 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2603
Practice Address - Country:US
Practice Address - Phone:909-464-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROMA MARKETING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-21
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7274750001Medicare NSC