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NPI Code Detail

MEDICARE: DR. JULIA SERENE MARRYSHOW PHARMD

MEDICARE: DR. JULIA SERENE MARRYSHOW PHARMD
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
1183500000XPharmacist18023NV

General Provider Information

NPI Number : 1326393232
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIA SERENE MARRYSHOW PHARMD
Provider Business Mailing Address
First Line : 8750 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-5452
Country : US
Telephone Number : 702-933-2315
Fax Number : 702-570-4120
Provider Business Practice Location Address
First Line : 8750 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-5452
Country : US
Telephone Number : 702-933-2315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2012
Last Update Date : 08/19/2014

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