Mark A Graybeal
Individual provider Active NPI Pharmacist · Middletown, DE
NPI 1295927689 · NPPES record last updated Aug 10, 2007
Key facts
- NPI
- 1295927689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- A1-0002245 (DE)
- Practice address
- 2470 N Dupont Pkwy
Middletown, DE 19709-9653 - Phone
- (302) 376-9743
- NPI assigned
- Aug 10, 2007
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A1-0002245 | DE | MD | Pharmacist |
| 12675 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | A1-0002245 | DE | Yes |
| Pharmacist | 183500000X | 12675 | MD |
Addresses
Primary practice location
2470 N Dupont Pkwy
Middletown, DE 19709-9653
Mailing address
2470 N Dupont Pkwy
Middletown, DE 19709-9653
Phone (302) 376-9743
Other providers in Middletown, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2007. 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.