Provider Demographics
NPI:1760783906
Name:CASNER, HARK
Entity Type:Individual
Prefix:
First Name:HARK
Middle Name:
Last Name:CASNER
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:PO BOX 881030
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80488-1030
Mailing Address - Country:US
Mailing Address - Phone:970-879-2503
Mailing Address - Fax:
Practice Address - Street 1:37500 E. US HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80488-1030
Practice Address - Country:US
Practice Address - Phone:970-879-2503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist