Individual
MARK BENEDETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 TYGART MALL LOOP, FAIRMONT, WV 26554-2187
(304) 366-9115
(304) 366-1583
Mailing address
37 MULBERRY LN, BRIDGEPORT, WV 26330-9326
(304) 669-7066
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0003827
WV
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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