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General NPI Number Information
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NPI Number | 1437084951
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Entity Type | Individual
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Provider Name | MARK PAUL CELEBRE R.PH.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 4536 22ND AVE
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City | KENOSHA
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State | WI
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Zip | 53140-5917
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Country | US
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Telephone | 262-771-3558
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Fax | 262-649-1977
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Provider Business Mailing Address
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Address Line | 4006 WASHINGTON RD
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City | KENOSHA
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State | WI
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Zip | 53144-4819
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Country | US
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Telephone | 262-771-3558
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Fax | 262-649-1977
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 10294-40
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10294-40
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License Number State | WI
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