MEDICARE: MARILYN MCENTEE RPH

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	183500000X	Pharmacist	47565	CA

General Provider Information

NPI Number	:	1437430667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN MCENTEE RPH

Provider Business Mailing Address
First Line	:	1301 MARKET ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-1307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 MARKET ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-1307
Country	:	US
Telephone Number	:	415-861-4010
Fax Number	:	415-861-2777

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

Provider Enumeration Date	:	09/01/2011
Last Update Date	:	09/01/2011

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