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General NPI Number Information
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NPI Number | 1992889323
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Entity Type | Organization
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Legal Business Name | SEMCA PHARMACY
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 286 EUCLID AVE STE 206
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City | SAN DIEGO
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State | CA
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Zip | 92114-3610
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Country | US
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Telephone | 619-263-6635
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Fax | 619-263-4686
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Provider Business Mailing Address
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Address Line | 286 EUCLID AVE STE 206
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City | SAN DIEGO
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State | CA
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Zip | 92114-3610
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Country | US
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Telephone | 619-263-6635
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Fax | 619-263-4686
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Authorized Official
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Title or Position | PHARMACIST/VICE PRESIDENT
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Name | MR. MARK LEROY DIMRY
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Credential | RPH
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Telephone | 619-263-6635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY409470
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License Number State | CA
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