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General NPI Number Information
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NPI Number | 1861107161
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Entity Type | Individual
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Provider Name | MARK CHRISTIAN PRICE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/20/2023
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 13907 HIGH RD
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City | MABELVALE
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State | AR
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Zip | 72103-3212
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Country | US
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Telephone | 501-451-7715
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Fax |
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Provider Business Mailing Address
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Address Line | 3151 HIGHWAY 35
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City | BENTON
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State | AR
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Zip | 72015-6101
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Country | US
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Telephone | 501-231-0613
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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 | PD10482
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License Number State | AR
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