Healthcare Provider Details

I. General information

NPI: 1871250233
Provider Name (Legal Business Name): SAMUEL LAWRENCE SEMEL RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 11/19/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 DEKALB PIKE
NORTH WALES PA
19454
US

IV. Provider business mailing address

205 HARMONY CT
BENSALEM PA
19020-3140
US

V. Phone/Fax

Practice location:
  • Phone: 215-661-0141
  • Fax:
Mailing address:
  • Phone: 215-450-4802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP456242
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: