Active NPI
Mark Russell McClain, R.PH.
- Pharmacist
- Albuquerque, NM
National Provider Identifier
1619399771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP00005383
- Practice address
- 801 Vassar Dr NE
Albuquerque, NM 87106-2725 - Phone
- (505) 248-4027
- Fax
- (505) 248-7642
- NPI assigned
- Jan 9, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP00005383 | NM | Primary |
| Pharmacist | 183500000X | RPH 46073 | CA |
Addresses
Primary practice location
801 Vassar Dr NE
Albuquerque, NM 87106-2725
Mailing address
801 Vassar Dr NE
Albuquerque, NM 87106-2725
Phone (505) 248-4027
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 |
|---|---|---|---|
| RPH 46073 | CA | MD | Pharmacist |
| RP00005383 | NM | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389225600000",
"number": "1619399771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 VASSAR DR NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871062725",
"telephone_number": "505-248-4027",
"fax_number": "505-248-7642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 VASSAR DR NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871062725",
"telephone_number": "505-248-4027",
"fax_number": "505-248-7642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLAIN",
"first_name": "MARK",
"middle_name": "RUSSELL",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-09",
"last_updated": "2014-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "RP00005383",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 46073",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.