Mark Michael Stephan, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP443961 Issued in PA

Practice address

2030 Fruitville Pike
Lancaster, PA 17601-3998

Phone

(717) 581-1500

Fax

(717) 581-7813

NPI assigned

Oct 27, 2020

Last updated

Oct 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wal-Mart Stores East LP

  dba Wal-Mart Pharmacy 10-5200

  • Community/Retail Pharmacy
  • Lancaster, PA
  • NPI 1760409908
  NPD (past)
• Wal-Mart Stores East, LP

  dba Walmart Pharmacy 10-2229

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1235739467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 E CHESTNUT ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022742",
            "telephone_number": "717-475-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 FRUITVILLE PIKE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176013998",
            "telephone_number": "717-581-1500",
            "fax_number": "717-581-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHAN",
        "first_name": "MARK",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP443961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RP443961",
            "identifier": "RP443961",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "walmart",
            "affiliation": "N",
            "endpointDescription": "pharmacy",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "walmart",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pharmacy",
            "address_1": "2030 Fruitville Pike",
            "city": "Lancaster",
            "state": "PA",
            "country_code": "US",
            "postal_code": "176013998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.