Provider Demographics
NPI:1497756514
Name:RECKER, MARK W (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:W
Last Name:RECKER
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 1:232 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS GROVE
Mailing Address - State:OH
Mailing Address - Zip Code:45830-9463
Mailing Address - Country:US
Mailing Address - Phone:419-659-6250
Mailing Address - Fax:419-226-5138
Practice Address - Street 1:1001 BELLEFONTAINE AVE
Practice Address - Street 2:LIMA MEMORIAL HOSPITAL PHARMACY
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2800
Practice Address - Country:US
Practice Address - Phone:419-998-4524
Practice Address - Fax:419-226-5138
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-17380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist