Mark Oleson

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

18473 Issued in IA

Practice address

1905 E 7TH St
Atlantic, IA 50022-1916

Phone

(712) 243-9223

Fax

(712) 243-9225

NPI assigned

Dec 2, 2018

Last updated

Oct 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1543708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1023588159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BROAD ST",
            "city": "ADAIR",
            "state": "IA",
            "postal_code": "500021015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 E 7TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221916",
            "telephone_number": "712-243-9223",
            "fax_number": "712-243-9225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Broad Street",
            "address_purpose": "LOCATION",
            "city": "Adair",
            "state": "IA",
            "postal_code": "50002",
            "country_code": "US",
            "telephone_number": "641-757-0130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLESON",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-02",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "18473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Atlantic, IA
• Providers in Atlantic, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.