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General NPI Number Information
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NPI Number | 1831210848
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Entity Type | Individual
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Provider Name | JONATHAN SCOTT MARKS R.PH.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 805 S LONG DR
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City | ROCKINGHAM
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State | NC
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Zip | 28379-4317
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Country | US
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Telephone | 910-997-4471
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Fax | 910-997-4951
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Provider Business Mailing Address
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Address Line | 110 DOUBLE L RD
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City | ROCKINGHAM
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State | NC
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Zip | 28379-9481
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Country | US
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Telephone | 910-997-4471
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Fax | 910-997-4951
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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 | 13886
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License Number State | NC
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