Active NPI
Mark Wager
- Ambulatory Care Pharmacist
- Phoenix, AZ
National Provider Identifier
1184403164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- I025269
- Practice address
- 9201 W Thomas Rd
Phoenix, AZ 85037-3332 - Phone
- (623) 327-6170
- NPI assigned
- Sep 27, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | I025269 | AZ | Primary |
Addresses
Primary practice location
9201 W Thomas Rd
Phoenix, AZ 85037-3332
Mailing address
5421 S Southern Oak Dr
Tucson, AZ 85746-1345
Phone (520) 329-7563
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I025269 | AZ | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695772800000",
"number": "1184403164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5421 S SOUTHERN OAK DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857461345",
"telephone_number": "520-329-7563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9201 W THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850373332",
"telephone_number": "623-327-6170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGER",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-27",
"last_updated": "2023-09-27",
"certification_date": "2023-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "AZ",
"license": "I025269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.