Provider Demographics
NPI:1164792594
Name:STRICKLAND, MARK EDWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:EDWARD
Last Name:STRICKLAND
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 1:14 PLYMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1734
Mailing Address - Country:US
Mailing Address - Phone:207-282-5591
Mailing Address - Fax:
Practice Address - Street 1:91 AUBURN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-6008
Practice Address - Country:US
Practice Address - Phone:207-797-0536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME4237183500000X
VT0330003780183500000X
NHR2153183500000X
MAPH22593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist