Provider Demographics
NPI:1275819310
Name:SIMENTAL, MARIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:SIMENTAL
Suffix:
Gender:F
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 2937
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:WY
Mailing Address - Zip Code:83128-3902
Mailing Address - Country:US
Mailing Address - Phone:307-654-6337
Mailing Address - Fax:307-654-6338
Practice Address - Street 1:168 US HWY 89
Practice Address - Street 2:SUITE D
Practice Address - City:ALPINE
Practice Address - State:WY
Practice Address - Zip Code:83128-3902
Practice Address - Country:US
Practice Address - Phone:307-654-6337
Practice Address - Fax:307-654-6338
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3028183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist