Organization
KENNEBEC PHARMACY AND HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TED NATHAN TREBILCOCK (CONTROLLER)
(207) 626-2726
Entity
Organization
Contact information
Practice address
121 MEDICAL CENTER DR, STE G500, BRUNSWICK, ME 04011-2653
(207) 729-3642
(207) 729-2704
Mailing address
43 LEIGHTON RD, AUGUSTA, ME 04330-7705
(207) 626-2726
(207) 729-2704
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110020000
—
ME
01
—
2000951
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/08/2006
Last updated
09/23/2025
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