Mark Antun, B.S.
Individual provider Active NPI Pharmacist · Natick, MA
NPI 1083997167 · NPPES record last updated Sep 24, 2011
Key facts
- NPI
- 1083997167
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 24776 (MA)
- Practice address
- 148 W Central St
Natick, MA 01760-4106 - Phone
- (508) 653-3303
- Fax
- (508) 652-0816
- NPI assigned
- Sep 24, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24776 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 24776 | MA | Yes |
Addresses
Primary practice location
148 W Central St
Natick, MA 01760-4106
Mailing address
148 W Central St
Natick, MA 01760-4106
Other providers in Natick, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.