Provider Demographics
NPI:1508887571
Name:MARKS FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:MARKS FAMILY PHARMACY LLC
Other - Org Name:MARKS FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-569-7800
Mailing Address - Street 1:PO BOX 5145
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-5145
Mailing Address - Country:US
Mailing Address - Phone:423-569-7800
Mailing Address - Fax:423-569-7801
Practice Address - Street 1:205 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-2710
Practice Address - Country:US
Practice Address - Phone:423-569-7800
Practice Address - Fax:423-569-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39153336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2093972OtherPK