Mark Alexander Whittier, RPH
Individual provider Active NPI Pharmacist · Canby, MN
NPI 1124876503 · NPPES record last updated May 9, 2024
Key facts
- NPI
- 1124876503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 114024 (MN)
- Practice address
- 130 Saint Olaf Ave N
Canby, MN 56220-1372 - Phone
- (507) 223-5955
- NPI assigned
- May 9, 2024
- 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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114024 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canby Drug & Gifts Inc | Current |
Accepting new patients | |
| Canby Drug & Gifts Inc | Current |
Accepting new patients |
Locations
130 Saint Olaf Ave N
Canby, MN 56220
Phone (507) 223-5955
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 114024 | MN | Yes |
Addresses
Primary practice location
130 Saint Olaf Ave N
Canby, MN 56220-1372
Mailing address
103 Lexington Ave
Canby, MN 56220-9272
Phone (507) 829-4169
Other practice location 1
103 Lexington Ave
Canby, MN 56220-9272
Phone (507) 829-4169
Other providers in Canby, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2024. 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.