Provider Demographics
NPI:1629796032
Name:SEMEROD, STANLEY J JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:J
Last Name:SEMEROD
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:25 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:PA
Mailing Address - Zip Code:15340-1169
Mailing Address - Country:US
Mailing Address - Phone:412-495-1515
Mailing Address - Fax:724-249-6205
Practice Address - Street 1:25 MAIN ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:PA
Practice Address - Zip Code:15340-1169
Practice Address - Country:US
Practice Address - Phone:412-495-1515
Practice Address - Fax:724-249-6205
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036877L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP036877LOtherCOMMONWEALTH OF PA DEPT OF STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIR