=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306114525
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSEMARY TETTEH MARCHAL PHARM D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/02/2011
-----------------------------------------------------
Last Update Date | 12/02/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 W BROWARD BLVD
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33312-1748
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-309-0174
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 700 W BROWARD BLVD
-----------------------------------------------------
City | FORT LAUDERD ALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-309-0174
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PS41679
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------