Active NPI
Mark Fondriest, RPH, DPLA
- Pharmacist
- Bedford, OH
National Provider Identifier
1205306370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03223754
- Practice address
- 44 Blaine Ave
Bedford, OH 44146-2709 - Phone
- (440) 735-3595
- NPI assigned
- Nov 30, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03223754 | OH | Primary |
Addresses
Primary practice location
44 Blaine Ave
Bedford, OH 44146-2709
Mailing address
3821 Pinwood Cir
Norton, OH 44203-9505
Phone (614) 314-2356
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03223754 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543536000000",
"number": "1205306370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3821 PINWOOD CIR",
"city": "NORTON",
"state": "OH",
"postal_code": "442039505",
"telephone_number": "614-314-2356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 BLAINE AVE",
"city": "BEDFORD",
"state": "OH",
"postal_code": "441462709",
"telephone_number": "440-735-3595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONDRIEST",
"first_name": "MARK",
"credential": "RPH, DPLA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-30",
"last_updated": "2018-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03223754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.