Provider Demographics
NPI:1689277246
Name:ERSKINE, MARK
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ERSKINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 BOGUE RD
Mailing Address - Street 2:
Mailing Address - City:WEARE
Mailing Address - State:NH
Mailing Address - Zip Code:03281-5600
Mailing Address - Country:US
Mailing Address - Phone:603-860-1565
Mailing Address - Fax:
Practice Address - Street 1:73 FORT EDDY RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7405
Practice Address - Country:US
Practice Address - Phone:603-228-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist