Active NPI
Mark Lucian Demmer, RPH
- Pharmacist
- Kingman, AZ
National Provider Identifier
1558742684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14157
- Practice address
- 1745 Miami Ave
Kingman, AZ 86401-4020 - Phone
- (928) 542-5554
- NPI assigned
- Jun 15, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | 14157 | AZ | Primary |
Addresses
Primary practice location
1745 Miami Ave
Kingman, AZ 86401-4020
Mailing address
1745 Miami Ave
Kingman, AZ 86401-4020
Phone (928) 542-5554
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 |
|---|---|---|---|
| 14157 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434326400000",
"number": "1558742684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1745 MIAMI AVE",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864014020",
"telephone_number": "928-542-5554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1745 MIAMI AVE",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864014020",
"telephone_number": "928-542-5554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMMER",
"first_name": "MARK",
"middle_name": "LUCIAN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-15",
"last_updated": "2015-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "14157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingman, AZ
- Kerry Deering, OTR
- Kimberley Kiel Deering, PT
- Maryssa Del Monaco, PA
- Staci Rene' Delaney, LPC
- Rachel Rae Delfino Briles, FNP-C
- Desert Family Eye Center, P.C.
- Desert Rose Management Corp (Desert Rose Imaging Center)
- Desert West Pharmacy Inc (Desert West Pharmacy)
- Diagnostic Solutions, LLC
- Diagnostic Ultrasound Solutions, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.