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General NPI Number Information
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NPI Number | 1568136836
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Entity Type | Individual
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Provider Name | SAMANTHA SEDOTTO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | N56W15501 SILVER SPRING DR.
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City | MENOMONCE FALLS
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State | WI
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Zip | 53051
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Country | US
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Telephone | 262-703-9781
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Fax |
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Provider Business Mailing Address
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Address Line | N56W15501 SILVER SPRING DR.
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City | MENOMONCE FALLS
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State | WI
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Zip | 53051
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Country | US
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Telephone |
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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 | P564152
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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 | 22603-40
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2021030458
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License Number State | MO
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