Provider Demographics
NPI:1831304310
Name:HARDY, MARK JAMES (PHARM D CANDIDATE)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:JAMES
Last Name:HARDY
Suffix:
Gender:M
Credentials:PHARM D CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:NECHE
Mailing Address - State:ND
Mailing Address - Zip Code:58265-0006
Mailing Address - Country:US
Mailing Address - Phone:701-886-7574
Mailing Address - Fax:
Practice Address - Street 1:201 EAST 3RD AVE S
Practice Address - Street 2:
Practice Address - City:CAVALIER
Practice Address - State:ND
Practice Address - Zip Code:58220-0000
Practice Address - Country:US
Practice Address - Phone:701-265-4744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1037390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program