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General NPI Number Information
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NPI Number | 1336464825
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Entity Type | Organization
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Legal Business Name | JEFFREY A MARKS
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 9 WEST MAIN STREET
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City | FRIENDSHIP
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State | NY
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Zip | 14739
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Country | US
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Telephone | 585-973-3496
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Fax | 585-973-3631
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Provider Business Mailing Address
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Address Line | 9 WEST MAIN STREET PO BOX 128
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City | FRIENDSHIP
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State | NY
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Zip | 14739
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Country | US
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Telephone | 585-973-3496
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Fax | 585-973-3631
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Authorized Official
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Title or Position | OWNER/SUPERVISING PHARMACIST
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Name | MR. JEFFREY A MARKS
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Credential | R.PH
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Telephone | 585-610-2869
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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 | 021983
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License Number State | NY
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