National Provider Identifier

Mark William Fagnan, RPH

Mark William Fagnan, RPH is listed in the NPPES registry with a primary specialty of Pharmacist in Horseheads, NY and a listed phone number of (607) 739-0301.

NPI 1942480520Horseheads, NYPharmacist

Profile Overview

NPI
1942480520
Provider Type
Individual
Primary Specialty
Pharmacist
Enumeration Date
November 12, 2007
Last Updated
November 17, 2007

Practice Location

  • 507 Chemung St
  • Horseheads, NY 14845-2711

Phone: (607) 739-0301

Mailing Address

  • PO Box 696
  • Montour Falls, NY 14865-0696

Specialties

  • Pharmacist (183500000X)
Full Record
NPI
1942480520
Entity Type
Individual
Last Name
Fagnan
First Name
Mark
Middle Name
William
Name Prefix
Mr.
Credential
RPH
Mailing Street Address
PO Box 696
Mailing City
Montour Falls
Mailing State
NY
Mailing ZIP Code
14865-0696
Mailing Country
US
Mailing Phone
(607) 426-9754
Practice Street Address
507 Chemung St
Practice City
Horseheads
Practice State
NY
Practice ZIP Code
14845-2711
Practice Country
US
Practice Phone
(607) 739-0301
Enumeration Date
November 12, 2007
Last Updated
November 17, 2007
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pharmacist (183500000X)
Other Identifiers
00352098 (NY)