MEDICARE: MR. MICHAEL GEORGE MARCUS R.PH.

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	RP028104L	PA

General Provider Information

NPI Number	:	1720357379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL GEORGE MARCUS R.PH.

Provider Business Mailing Address
First Line	:	3401 PEBBLE RIDGE DR
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-4349
Country	:	US
Telephone Number	:	717-324-0310
Fax Number	:	717-505-9927

Provider Business Practice Location Address
First Line	:	3401 PEBBLE RIDGE DR
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-4349
Country	:	US
Telephone Number	:	717-324-0310
Fax Number	:	717-505-9927

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

Provider Enumeration Date	:	12/27/2011
Last Update Date	:	12/27/2011

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