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General NPI Number Information
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NPI Number | 1558915801
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Entity Type | Individual
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Provider Name | MEGHAN ELIZABETH MARK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 2300 RAMSEY ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-3856
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Country | US
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Telephone | 910-488-2120
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 RAMSEY ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-3856
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Country | US
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Telephone | 630-536-7160
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 37789
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 37789
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License Number State | SC
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