Provider Demographics
NPI:1194320010
Name:ROMINGER, CANDICE JEWEL (RPH)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:JEWEL
Last Name:ROMINGER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:JEWEL
Other - Last Name:ROMINGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:9651 S COUNTY ROAD 400 E
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:IN
Mailing Address - Zip Code:46994-9252
Mailing Address - Country:US
Mailing Address - Phone:765-623-9887
Mailing Address - Fax:
Practice Address - Street 1:720 N BROADWAY
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-1027
Practice Address - Country:US
Practice Address - Phone:765-473-5542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019912A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist