Provider Demographics
NPI:1366044729
Name:BELL, MARK RICHARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:RICHARD
Last Name:BELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MARKIE DR W
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-4551
Mailing Address - Country:US
Mailing Address - Phone:585-530-0998
Mailing Address - Fax:
Practice Address - Street 1:335 CRYSTAL LN
Practice Address - Street 2:
Practice Address - City:STRASBURG
Practice Address - State:VA
Practice Address - Zip Code:22657-2364
Practice Address - Country:US
Practice Address - Phone:540-465-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0012277333600000X
VA0202219139333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy