Provider Demographics
NPI:1891093027
Name:SANDERS, MARK F (RPH)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:F
Last Name:SANDERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 AVENT FERRY RD # 133
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2138
Mailing Address - Country:US
Mailing Address - Phone:919-833-5531
Mailing Address - Fax:
Practice Address - Street 1:2233 AVENT FERRY RD # 133
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2138
Practice Address - Country:US
Practice Address - Phone:919-833-5531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist