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Individual

MRS. RENEE MICHELLE FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 973-6654
(207) 973-4781
Mailing address
21 COUNTRY WAY, BREWER, ME 04412-1652
(207) 989-1253

Taxonomy

Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
3328
RI
1835P1200X
Pharmacotherapy Pharmacist
Primary
4304
ME

Other

Enumeration date
07/28/2005
Last updated
07/09/2012
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