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General NPI Number Information
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NPI Number | 1346527710
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Entity Type | Individual
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Provider Name | MARK LANASA PARKS CPHT
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Gender | Male
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Dates
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Enumeration Date | 11/13/2011
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 200 HAWTHORNE LN 3RD FLOOR PHARMACY
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City | CHARLOTTE
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State | NC
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Zip | 28204-2515
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Country | US
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Telephone | 704-384-9480
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Fax | 704-316-4496
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Provider Business Mailing Address
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Address Line | 5031 WAXHAW CROSSING DR
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City | WAXHAW
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State | NC
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Zip | 28173-2400
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Country | US
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Telephone | 704-616-9915
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State | NC
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