Provider Demographics
NPI:1902599624
Name:LAWRENCE, MARK THOMAS (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:THOMAS
Last Name:LAWRENCE
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 1:5700 PERIMETER DR STE B
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3253
Mailing Address - Country:US
Mailing Address - Phone:614-850-6700
Mailing Address - Fax:
Practice Address - Street 1:5700 PERIMETER DR STE B
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3253
Practice Address - Country:US
Practice Address - Phone:614-850-5700
Practice Address - Fax:614-559-5775
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-170841835C0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0207XPharmacy Service ProvidersPharmacistCompounded Sterile Preparations