Provider Demographics
NPI:1245391325
Name:SEMPREBON, MARC ALLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:ALLEN
Last Name:SEMPREBON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 114
Mailing Address - Street 2:
Mailing Address - City:BEEBE PLAIN
Mailing Address - State:VT
Mailing Address - Zip Code:05823-0114
Mailing Address - Country:US
Mailing Address - Phone:802-873-9677
Mailing Address - Fax:
Practice Address - Street 1:350 FISHER ROAD
Practice Address - Street 2:VERMONT PSYCHIATRIC CARE HOSPITAL
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602
Practice Address - Country:US
Practice Address - Phone:802-828-3092
Practice Address - Fax:802-828-2588
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.00036861835P1200X
NH22251835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy