Healthcare Provider Details

I. General information

NPI: 1578975884
Provider Name (Legal Business Name): CHRIS SEMENZA PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 05/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1628 CHESTNUT ST
PHILADELPHIA PA
19103-5119
US

IV. Provider business mailing address

1628 CHESTNUT ST
PHILADELPHIA PA
19103-5119
US

V. Phone/Fax

Practice location:
  • Phone: 215-972-0234
  • Fax:
Mailing address:
  • Phone: 215-972-0234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP445589
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: