MR. MARK DEWITT ALLEN (NPI# 1902174022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902174022 |
Entity Type | Individual |
Full Name | MR. MARK DEWITT ALLEN |
Credential | RPH. |
Practice Address |
3445 Terry Rd Jackson MS 39212-4956 |
Practice Telephone | 6013728750 |
Practice Fax Number | 6013723833 |
Mailing Telephone | 6013728750 |
Mailing Fax Number | 6013723833 |
Enumeration Date | 2011-12-03 |
Last Update Date | 2011-12-03 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
E-07742 | MS | Pharmacy Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720539406 | Mark Allen | Nursing Facility/Intermediate Care Facility | 219 Deerfoot Trl, Kalispell, MT 59901-8725 | 2016-10-18 |
1942509559 | Mark Allen | Counselor | 1384 W Ellery Way, Fresno, CA 93711-2014 | 2011-03-22 |
1124339676 | Mark Allen | Orthopaedic Surgery | 1505 Wigwam Pkwy Ste 330, Henderson, NV 89074 | 2010-06-30 |
1134283765 | Mark S Allen | Dentist | 1716 Ashley Cir, Bowling Green, KY 42104-3366 | 2006-12-20 |
1952471617 | Mark Allen | Chiropractor | 434 S Green St, Henderson, KY 42420-3517 | 2006-11-09 |
1306934708 | Mark A. Allen | Chiropractor | 2525 California St, Suite A&b, Columbus, IN 47201-3678 | 2006-10-11 |
1467551549 | Mark H Allen | Optometrist | 4810 Lakeland Dr, Flowood, MS 39232-8694 | 2006-09-22 |
1295742013 | Mark Jay Allen | Dentist | 519 S Santa Fe Ave, Edmond, OK 73003-6281 | 2006-08-02 |
1700842549 | Mark Allen | Dentist | 151 North Main St, Hardwick, VT 05843 | 2006-04-21 |
1932187507 | Mark Daniel Allen | Nurse Practitioner | 1400 Willow Lane, Manchester, TN 37355 | 2006-01-04 |
Street Address |
3445 TERRY RD |
City | JACKSON |
State | MS |
Zip Code | 39212-4956 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730184607 | Amber Dione Wilbanks | Pharmacist | 3445 Terry Rd, Jackson, MS 39212-4956 | 2005-06-16 |
1396015111 | Jennifer Eileen Taylor Iv | Pharmacist | 3445 Terry Rd, Jackson, MS 39212-4956 | 2012-01-10 |
1972871895 | Tiawana Ware Alexander | Pharmacist | 3445 Terry Rd, Jackson, MS 39212-4956 | 2011-12-06 |
1104831361 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3445 Terry Rd, Jackson, MS 39212-4956 | 2006-07-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013406172 | South Central Community Action Agency, Inc | Non-emergency Medical Transport (VAN) | 3891 I-55 South Frontage Rd, Jackson, MS 39212 | 2018-05-04 |
1508305780 | Caring Companions LLC | Home Health | 1024 Cooper Rd, Jackson, MS 39212 | 2017-02-21 |
1750634044 | Christians In Action, Inc. | Community/Behavioral Health | 2025 North Siwell Rd, Jackson, MS 39212 | 2012-10-24 |
1609164748 | Counseling and Mentoring Program | Community/Behavioral Health | 2964 Terry Road B-1, Jackson, MS 39212 | 2011-07-11 |
1407179039 | Caring Hands Community Services Inc | Skilled Nursing Facility | 3318 Longwood Drive, Jackson, MS 39212 | 2010-03-10 |
1992239404 | Shaemik Harris | Registered Nurse | 3520 Sykes Park Dr, Jackson, MS 39212 | 2017-04-12 |
1780044438 | Alfonzo Haralson | Counselor | 132 Thousand Oaks Cir, Jackson, MS 39212-2046 | 2016-02-24 |
1659384063 | Kentrell Marie Liddell | Family Medicine | 2104 Thousand Oaks Dr, Jackson, MS 39212-2048 | 2006-08-15 |
1649819590 | George Cavett Jr. | Nurse Practitioner | 2450 Twisted Oak Dr, Jackson, MS 39212-2137 | 2019-12-24 |
1912455361 | Victorious Healthcare L.L.C. | Assisted Living Facility | 4959 Laurel Oak Dr, Jackson, MS 39212-2150 | 2016-09-14 |
Find all providers in zip 39212 |
Taxonomy Code | 1835P1200X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Pharmacotherapy |
A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871993972 | Thomas A Webb | Pharmacist | 1500 E Woodrow Wilson Ave # Slot119, Jackson, MS 39216-5116 | 2014-08-26 |
1093986259 | Julie Searfoss George | Pharmacist | 350 West Woodrow Wilson Boulevard, Jackson, MS 39213 | 2008-03-17 |
1801418843 | Jamie Wagner | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-05-13 |
1124666300 | Henderson Delmar Warnock IIi | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2019-12-18 |
1174933436 | Haritha Natla | Pharmacist | 3333 E Michigan Ave, Jackson, MI 49202-3853 | 2014-05-07 |
1477963890 | James Cheney | Pharmacist | 2777 Airport Rd, Jackson, MI 49202-1239 | 2014-05-07 |
1275943920 | Pamela Jean Rose | Pharmacist | 2777 Airport Rd, Jackson, MI 49202-1239 | 2014-05-03 |
1477963106 | Renee Moran | Pharmacist | 3333 E Michigan Ave, Jackson, MI 49202-3853 | 2014-05-02 |
1467883298 | Amber Deanne Grantham | Pharmacist | 93 Stonebrook Pl, Target Pharmacy, Jackson, TN 38305-3637 | 2013-12-04 |
1972871895 | Tiawana Ware Alexander | Pharmacist | 3445 Terry Rd, Jackson, MS 39212-4956 | 2011-12-06 |
Find all providers in JACKSON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.