MR. MARK C ANDERSON (NPI# 1376635425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376635425 |
| Entity Type | Individual |
| Full Name | MR. MARK C ANDERSON |
| Credential | RPH |
| Practice Address |
530 2nd St Mickleson Drug Inc Hudson WI 54016 |
| Mailing Address |
715 Lake Dr Stillwater MN 55082 |
| Practice Telephone | 7153863344 |
| Practice Fax Number | 7153865198 |
| Mailing Telephone | 6514395295 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 1142750 | MN | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 10955040 | WI | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33003000 | 05 | |
| DEA | AM3909136 | 01 | |
| NAPB | 5106275 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326607383 | Mark Anderson | Massage Therapist | 1978 Addison Ave E, Twin Falls, ID 83301-5304 | 2019-06-12 |
| 1427403468 | Mark Anthony Anderson | Student in an Organized Health Care Education/Training Program | 157 E Rose St, Lebanon, OR 97355-4231 | 2016-04-27 |
| 1356732887 | Mark David Anderson | Licensed Practical Nurse | 227 Island Cottage Rd., Rochester, NY 14612-3627 | 2015-02-05 |
| 1134562903 | Mark William Anderson | Marriage & Family Therapist | 500 S. 580 W., Escalante, UT 84726 | 2013-04-11 |
| 1629334073 | Mark Gruen Anderson | Pharmacist | 2615 Eastern Ave, Plymouth, WI 53073-4270 | 2012-04-10 |
| 1629342928 | Mark Anderson | Social Worker | 140 Griggs Dr, Princeton, NJ 08540-7672 | 2012-03-05 |
| 1912271818 | Mark D Anderson | Licensed Practical Nurse | 4210 Wood Park Dr, Stow, OH 44224-2651 | 2012-02-24 |
| 1982905261 | Mark Alan Anderson | Pharmacist | 860 N Cleveland Ave, Loveland, CO 80537-4717 | 2010-11-03 |
| 1487822771 | Mark R Anderson | Counselor | 106 N Kenosha Dr, Madison, WI 53705-2633 | 2008-02-20 |
| 1174736953 | Mark Arthur Anderson | Specialist | 333 O'connor Dr, San Jose, CA 95128 | 2007-05-08 |
| Street Address |
530 2ND ST MICKLESON DRUG INC |
| City | HUDSON |
| State | WI |
| Zip Code | 54016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033657283 | Micklesen Drug Inc | Pharmacy | 530 2nd St, Hudson, WI 54016-1799 | 2017-02-08 |
| 1215122981 | Lyle Willard Anderson | Pharmacist | 530 2nd St, Micklesen Drug Inc, Hudson, MI 54016 | 2007-09-06 |
| 1255489522 | Bruce R. Anderson | Pharmacist | 530 2nd St, Hudson, WI 54016-1512 | 2007-01-05 |
| 1245322304 | Richard Newberg | Pharmacist | 530 2nd St, Hudson, WI 54016 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921128 | Sara Lynn Henry | Occupational Therapy Assistant | 1320 Wisconsin St., Husdon, WI 54016 | 2018-02-06 |
| 1689003436 | Serving Hands Inc | Home Health | 1419 Boulder Court, Hudson, WI 54016 | 2013-11-02 |
| 1275973042 | Lisa Renee Haverly | Occupational Therapist | 477 Perch Lake Rd, Hudson, WI 54016 | 2013-06-26 |
| 1710320213 | Emily Ann Stevenson | Counselor | 901 4th St Ste 165, Hudson, WI 54016 | 2013-04-15 |
| 1083972954 | The Shurden Group | In Home Supportive Care | 2424 Monetary Blvd. #012, The Shurden Group Dba Comfort Keepers, Hudson, WI 54016 | 2012-04-30 |
| 1124305933 | Robert Michael Catlow-price | Massage Therapist | 131 Carmichael Road, Suite #202, Hudson, WI 54016 | 2011-11-08 |
| 1962780221 | Qin Chu | Acupuncturist | 1615 Maxwell Dr., Suite D, Hudson, WI 54016 | 2011-08-03 |
| 1124324231 | Hung Trieu Lieu | Acupuncturist | 1810 Crest View Dr Ste 4a, Hudson, WI 54016 | 2011-02-07 |
| 1912214966 | Sumac Residential LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 723 B Blue Jay Lane, Hudson, WI 54016 | 2010-09-10 |
| 1740593201 | Michelle Marie Young | Counselor | 2501 Hanley Road, Suite F, Eagle Valley Bank Building, Hudson, WI 54016 | 2010-07-26 |
| Find all providers in zip 54016 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952922197 | Lynne Marie Millson | Pharmacist | 10 Hillside Rd, Hudson, MA 01749-1355 | 2020-04-28 |
| 1952890816 | Eric Johnson | Pharmacist | 2351 Coulee Rd, Hudson, WI 54016-9177 | 2018-05-07 |
| 1700304599 | Mary Lee Carter | Pharmacist | 7135 State Road 52 Ste 103, Hudson, FL 34667-6748 | 2017-09-01 |
| 1831646488 | Laura Mansman | Pharmacist | 77 Derry Rd., Hudson Mall, Hudson, NH 03051 | 2016-09-01 |
| 1225584576 | Kyra Kristine Messina | Pharmacist | 77 Derry Rd, Hudson, NH 03051 | 2016-08-28 |
| 1174906903 | Apexx Pharmacy | Pharmacist | 10343 State Road 52, Hudson, FL 34669-3097 | 2015-06-29 |
| 1376946384 | Ashley Wolfe | Pharmacist | 2794 Hickory Blvd, Hudson, NC 28638-9101 | 2014-10-04 |
| 1215343439 | Steven Surrette | Pharmacist | 24a Chandler Ct, Hudson, NH 03051-6901 | 2014-07-08 |
| 1609281468 | Susan Lester | Pharmacist | 239 Brentwood Dr, Hudson, OH 44236-1637 | 2014-06-30 |
| 1528478351 | Carol Meyer | Pharmacist | 7528 Forthampton Cir, Hudson, OH 44236-4692 | 2014-05-01 |
| Find all providers in HUDSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.