Mark Andrew Kostelnik, PHARMD, BCPS

Primary specialty

Compounded Sterile Preparations PharmacistTaxonomy code 1835C0207X

License

PD14410 Issued in AR

Practice address

375 E Millsap Rd Ste 3
Fayetteville, AR 72703-6289

Phone

(918) 809-7822

Fax

(479) 445-6032

NPI assigned

Jul 22, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Infuserx, LLC

  • Home Infusion Therapy Pharmacy
  • Fayetteville, AR
  • NPI 1912448945
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1013220730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 E MILLSAP RD STE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036289",
            "telephone_number": "918-809-7822",
            "fax_number": "479-445-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E MILLSAP RD STE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036289",
            "telephone_number": "918-809-7822",
            "fax_number": "479-445-6032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTELNIK",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "credential": "PHARMD, BCPS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "14707",
            "primary": false
        },
        {
            "code": "1835C0207X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Compounded Sterile Preparations",
            "state": "AR",
            "license": "PD14410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anh Dao Kolbe
• Hessel Kooistra III, M.D.
• Linda Marie Kooistra, D.C.
• Abigail Marie Korpella
• Shelby Koshy
• Ashley Kotchin
• Shivani Koundinya
• Nicholas Stan Kowalkowski
• Joseph C Kradel II, MD
• Saran Kraichoke, M.D.

• Pharmacist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.