Provider Demographics
NPI:1033457676
Name:KRAL, MARK ANDREW (RPH)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ANDREW
Last Name:KRAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5885 CUMMING HWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-5765
Mailing Address - Country:US
Mailing Address - Phone:770-614-8866
Mailing Address - Fax:770-614-0671
Practice Address - Street 1:5885 CUMMING HWY
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-5765
Practice Address - Country:US
Practice Address - Phone:770-614-8866
Practice Address - Fax:770-614-0671
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist