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General NPI Number Information
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NPI Number | 1487460200
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Entity Type | Individual
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Provider Name | MARK PELLEGRINO PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 751 FOREST AVE STE 302
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City | ZANESVILLE
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State | OH
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Zip | 43701-2875
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Country | US
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Telephone | 740-455-7545
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 POORMMAN RD
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City | BELLVILLE
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State | OH
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Zip | 44813
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Country | US
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Telephone | 419-610-7389
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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 | 03223461
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License Number State | OH
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