Provider Demographics
NPI:1154331981
Name:SEMINGSON, BRUCE A (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:A
Last Name:SEMINGSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4967 E JUANA CT
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-6399
Mailing Address - Country:US
Mailing Address - Phone:602-678-1179
Mailing Address - Fax:602-687-0014
Practice Address - Street 1:7227 N 6TH WAY STE 160
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4969
Practice Address - Country:US
Practice Address - Phone:602-678-1179
Practice Address - Fax:602-687-0014
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4328183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4328OtherPHARMACIST'S LICENSE NUMB