Active NPI
Alex Charles Mareske, PHARMD
- Pharmacist
- Logan, WV
National Provider Identifier
1902406028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0010783
- Practice address
- 77 Norman Morgan Blvd
Logan, WV 25601-3477 - Phone
- (304) 752-7459
- NPI assigned
- Oct 28, 2020
- 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 | RP0010783 | WV | Primary |
Addresses
Primary practice location
77 Norman Morgan Blvd
Logan, WV 25601-3477
Mailing address
5014 Dempsey Dr
Cross Lanes, WV 25313-2004
Phone (304) 687-3226
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP0010783 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1902406028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5014 DEMPSEY DR",
"city": "CROSS LANES",
"state": "WV",
"postal_code": "253132004",
"telephone_number": "304-687-3226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 NORMAN MORGAN BLVD",
"city": "LOGAN",
"state": "WV",
"postal_code": "256013477",
"telephone_number": "304-752-7459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARESKE",
"first_name": "ALEX",
"middle_name": "CHARLES",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-28",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0010783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.