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General NPI Number Information
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NPI Number | 1558020206
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Entity Type | Organization
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Legal Business Name | PPADMARION LLC
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Dates
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Enumeration Date | 12/09/2021
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 1211 N MAIN ST
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City | MARION
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State | NC
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Zip | 28752-6367
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Country | US
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Telephone | 828-442-5421
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Fax | 828-659-9584
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Provider Business Mailing Address
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Address Line | 1211 N MAIN ST
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City | MARION
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State | NC
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Zip | 28752-6367
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Country | US
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Telephone | 828-442-5421
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Fax | 828-659-9584
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Authorized Official
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Title or Position | CO OWNER/AUTHORIZED OFFICIAL
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Name | ANDREW STOKER
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Credential | PHARMD
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Telephone | 828-575-6421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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