Provider Demographics
NPI:1528134707
Name:MARK IT PHARMACY INC
Entity type:Organization
Organization Name:MARK IT PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CARLE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:360-491-7521
Mailing Address - Street 1:3525 ENSIGN ROAD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506
Mailing Address - Country:US
Mailing Address - Phone:360-491-7521
Mailing Address - Fax:360-491-7522
Practice Address - Street 1:3525 ENSIGN ROAD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506
Practice Address - Country:US
Practice Address - Phone:360-491-7521
Practice Address - Fax:360-491-7522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6000558Medicaid
4917019OtherNABP