Provider Demographics
NPI:1407038698
Name:HARVEY, MARK REX (RPH)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:REX
Last Name:HARVEY
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 1:5031 QUIET FALLS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-0486
Mailing Address - Country:US
Mailing Address - Phone:775-530-9877
Mailing Address - Fax:
Practice Address - Street 1:5031 QUIET FALLS CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-0486
Practice Address - Country:US
Practice Address - Phone:775-530-9877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV8689OtherBOARD OF PHARMACY
AZ7438OtherBOARD OF PHARMACY
CA95834OtherBOARD OF PHARMACY