Provider Demographics
NPI:1730396250
Name:SANTOMASO, LAWRENCE JOHN (RPH)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:JOHN
Last Name:SANTOMASO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3883 MIRAMONTE AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4873
Mailing Address - Country:US
Mailing Address - Phone:970-667-8693
Mailing Address - Fax:970-622-1948
Practice Address - Street 1:2000 BOISE AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-5006
Practice Address - Country:US
Practice Address - Phone:970-622-1945
Practice Address - Fax:970-622-1948
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111841835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy