Provider Demographics
NPI:1053626010
Name:ROMMES, LAURA LYNN (PHARM-D)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:ROMMES
Suffix:
Gender:F
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5579
Mailing Address - Country:US
Mailing Address - Phone:541-471-4873
Mailing Address - Fax:
Practice Address - Street 1:111 UNION AVE
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5579
Practice Address - Country:US
Practice Address - Phone:541-471-4873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0010265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist