Active NPI
Mark Liu
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1902203995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP444068
- Practice address
- 1550 Pratt St
Philadelphia, PA 19124 - Phone
- (267) 686-8800
- Fax
- (267) 686-8745
- NPI assigned
- Nov 19, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP444068 | PA | Primary |
Addresses
Primary practice location
1550 Pratt St
Philadelphia, PA 19124
Mailing address
1550 Pratt St
Philadelphia, PA 19124-1923
Phone (267) 686-8800
Other practice location 1
338 E Allegheny Ave
Philadelphia, PA 19134-2321
Phone (215) 634-4397
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1030380870001 | Medicaid | PA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP444068 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellcare Pharmacy 2 | Current | Accepting new patients | |
| Rite Aid of Pennsylvania LLC | Past | Accepting new patients | |
| Rite Aid of Pennsylvania LLC | Past | Accepting new patients |
Locations
1550 Pratt St
Philadelphia, PA 19124
Phone (215) 533-9392
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Philadelphia, PA
- NPI 1720455819
-
- Community/Retail Pharmacy
- Philadelphia, PA
- NPI 1245329978
-
- Community/Retail Pharmacy
- Clearfield, PA
- NPI 1508431081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750982400000",
"number": "1902203995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1550 PRATT ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191241923",
"telephone_number": "267-686-8800",
"fax_number": "267-686-8745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 PRATT ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19124",
"telephone_number": "267-686-8800",
"fax_number": "267-686-8745"
}
],
"practiceLocations": [
{
"address_1": "338 E Allegheny Ave",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191342321",
"country_code": "US",
"telephone_number": "215-634-4397",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIU",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-19",
"last_updated": "2025-06-27",
"certification_date": "2025-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP444068",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1030380870001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.