Healthcare Provider Details

I. General information

NPI: 1427040245
Provider Name (Legal Business Name): MARK S. SIMKINS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ADIRONDACK MEDICAL CENTER 2233 STATE ROUTE 86
SARANAC LAKE NY
12983
US

IV. Provider business mailing address

8 SARANAC LN
SARANAC LAKE NY
12983-5907
US

V. Phone/Fax

Practice location:
  • Phone: 518-897-2378
  • Fax: 518-891-7615
Mailing address:
  • Phone: 518-891-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number038570-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: