Provider Demographics
NPI:1134503907
Name:ALLEN, MARK HARPER JR (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:HARPER
Last Name:ALLEN
Suffix:JR
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CANTING WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-8109
Mailing Address - Country:US
Mailing Address - Phone:864-525-7353
Mailing Address - Fax:
Practice Address - Street 1:7412 BROAD RIVER RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-9662
Practice Address - Country:US
Practice Address - Phone:803-749-3046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-11
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36136183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist