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General NPI Number Information
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NPI Number | 1073923108
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Entity Type | Individual
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Provider Name | MARK BAER PHARMACIST/RPH
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Gender | Male
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 121 W ELMSLEY ST
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City | GREENSBORO
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State | NC
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Zip | 27406-8276
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Country | US
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Telephone | 336-370-0353
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Fax | 336-370-0393
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Provider Business Mailing Address
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Address Line | 7607 BLUE SAGE CT
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City | SUMMERFIELD
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State | NC
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Zip | 27358-9346
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14189
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License Number State | NC
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