MEDICARE: DR. MARILYN ROSE SEMENCHUK PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1300X	Psychiatric Pharmacist	11311	AZ

General Provider Information

NPI Number	:	1083611479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARILYN ROSE SEMENCHUK PHARM.D.

Provider Business Mailing Address
First Line	:	16625 S 27TH LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85045-2207
Country	:	US
Telephone Number	:	480-460-2700
Fax Number	:	480-460-2855

Provider Business Practice Location Address
First Line	:	16625 S 27TH LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85045-2207
Country	:	US
Telephone Number	:	480-460-2700
Fax Number	:	480-460-2855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/08/2007

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