Healthcare Provider Details

I. General information

NPI: 1295011237
Provider Name (Legal Business Name): MARC BEJARNO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2011
Last Update Date: 10/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 E UNIVERSITY AVE
DES MOINES IA
50317-8236
US

IV. Provider business mailing address

2930 E UNIVERSITY AVE
DES MOINES IA
50317-8236
US

V. Phone/Fax

Practice location:
  • Phone: 515-299-5186
  • Fax: 515-299-5192
Mailing address:
  • Phone: 515-299-5186
  • Fax: 515-299-5192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20808
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: