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MARK E WANDEL NPI 1487737532


NPI Information

NPI: 1487737532
Provider Name: MARK E WANDEL

Doing Business As: BIG BEAR VALLEY MEDICAL ARTS PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
42002 FOX FARM RD
SUITE 103
BIG BEAR LAKE, CA
ZIP 92315
Phone: (909) 866-5881
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MARK E WANDEL is a community/retail pharmacy pharmacy in Big Bear Lake, CA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MARK E WANDEL NPI is 1487737532. The provider is registered as an organization entity type.
The provider Is Doing Business As Big Bear Valley Medical Arts Pharmacy.

The provider's business location address is:

42002 FOX FARM RD
SUITE 103
BIG BEAR LAKE, CA
ZIP 92315
Phone: (909) 866-5881
Fax: (909) 866-8510

The provider's authorized official is Mark Wandel .
The authorized official title is Owner and has the following contact phone number (909) 866-5881.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 9/21/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0004XPharmacyCompounding PharmacyNo
43336C0003XPharmacyCommunity/Retail PharmacyPHY44374CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PHA443740MEDICAIDCALIFORNIA
24556330001MEDICARE NSC
30557073OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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