MEDICARE: SHAWN SAMEIRO RPH., LAC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	40773	TN
2	183500000X	Pharmacist	S015073	AZ
3	171100000X	Acupuncturist	0928	AZ

General Provider Information

NPI Number	:	1629378773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN SAMEIRO RPH., LAC.

Provider Business Mailing Address
First Line	:	1119 MINERAL WELLS AVE
Second Line	:
City	:	PARIS
State	:	TN
Zip	:	38242-4903
Country	:	US
Telephone Number	:	731-642-4092
Fax Number	:

Provider Business Practice Location Address
First Line	:	1119 MINERAL WELLS AVE
Second Line	:
City	:	PARIS
State	:	TN
Zip	:	38242-4903
Country	:	US
Telephone Number	:	731-642-4092
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2010
Last Update Date	:	11/15/2016

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Directions to “ SHAWN SAMEIRO RPH., LAC.” Practice Location

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