MEDICARE: DR. SUZANNE M MARQUES 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	1835P1200X	Pharmacotherapy Pharmacist	03-2-17880	OH

General Provider Information

NPI Number	:	1568460335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZANNE M MARQUES PHARM.D.

Provider Business Mailing Address
First Line	:	130 ORCHARD DR
Second Line	:
City	:	ELIDA
State	:	OH
Zip	:	45807-1082
Country	:	US
Telephone Number	:	419-339-1553
Fax Number	:

Provider Business Practice Location Address
First Line	:	730 W MARKET ST
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-4602
Country	:	US
Telephone Number	:	419-226-9815
Fax Number	:	419-226-9866

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/08/2007

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