Provider Demographics
NPI:1427040245
Name:SIMKINS, MARK S (RPH)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:S
Last Name:SIMKINS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 SARANAC LN
Mailing Address - Street 2:
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-5907
Mailing Address - Country:US
Mailing Address - Phone:518-891-5544
Mailing Address - Fax:
Practice Address - Street 1:ADIRONDACK MEDICAL CENTER
Practice Address - Street 2:2233 STATE ROUTE 86
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983
Practice Address - Country:US
Practice Address - Phone:518-897-2378
Practice Address - Fax:518-891-7615
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY038570-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist