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NPI Code Detail

MEDICARE: MR. MARK STEPHEN LAZUR RPH

MEDICARE: MR. MARK STEPHEN LAZUR RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist21715MD
2183500000XPharmacistRP035378LPA

General Provider Information

NPI Number : 1871920967
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK STEPHEN LAZUR RPH
Provider Business Mailing Address
First Line : 130 ENTERPRISE DR
Second Line :
City : PITTSBURGH
State : PA
Zip : 15275-1213
Country : US
Telephone Number : 999-999-9999
Fax Number :
Provider Business Practice Location Address
First Line : 130 ENTERPRISE DR
Second Line :
City : PITTSBURGH
State : PA
Zip : 15275-1213
Country : US
Telephone Number : 999-999-9999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2013
Last Update Date : 10/27/2021

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