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General NPI Number Information
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NPI Number | 1013508977
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Entity Type | Individual
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Provider Name | STEVE B MARUSCHAK JR. PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 9052 INDEPENDENCE AVE
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City | DAPHNE
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State | AL
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Zip | 36526-5613
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Country | US
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Telephone | 800-873-7874
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Fax | 800-627-4838
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Provider Business Mailing Address
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Address Line | 3515 ARIZONA DR
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City | PENSACOLA
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State | FL
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Zip | 32504-4410
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Country | US
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Telephone | 850-860-9365
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 25273
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 15343
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License Number State | AL
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