Provider Demographics
NPI:1548873656
Name:ROMANO, CAROLYN (PHARMD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:ROMANO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17219 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-3024
Mailing Address - Country:US
Mailing Address - Phone:402-960-9034
Mailing Address - Fax:
Practice Address - Street 1:14000 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010
Practice Address - Country:US
Practice Address - Phone:531-355-5924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist