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General NPI Number Information
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NPI Number | 1245391325
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Entity Type | Individual
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Provider Name | MARC ALLEN SEMPREBON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 350 FISHER ROAD VERMONT PSYCHIATRIC CARE HOSPITAL
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City | BERLIN
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State | VT
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Zip | 05602
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Country | US
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Telephone | 802-828-3092
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Fax | 802-828-2588
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Provider Business Mailing Address
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Address Line | PO BOX 114
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City | BEEBE PLAIN
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State | VT
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Zip | 05823-0114
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Country | US
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Telephone | 802-873-9677
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 033.0003686
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 2225
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License Number State | NH
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