Provider Demographics
NPI:1699066233
Name:KEMPER, MARK J (PHARMD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:J
Last Name:KEMPER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 W INDEPENDENCE ST
Mailing Address - Street 2:
Mailing Address - City:SHAMOKIN
Mailing Address - State:PA
Mailing Address - Zip Code:17872-5314
Mailing Address - Country:US
Mailing Address - Phone:570-648-1021
Mailing Address - Fax:570-648-8121
Practice Address - Street 1:26 W INDEPENDENCE ST
Practice Address - Street 2:
Practice Address - City:SHAMOKIN
Practice Address - State:PA
Practice Address - Zip Code:17872-5314
Practice Address - Country:US
Practice Address - Phone:570-648-1021
Practice Address - Fax:570-648-8121
Is Sole Proprietor?:No
Enumeration Date:2011-05-01
Last Update Date:2011-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039043L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist