Organization
ELM CITY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ROY (OWNER)
(207) 861-7979
Entity
Organization
Contact information
Practice address
30 W CONCOURSE, WATERVILLE, ME 04901-6007
(207) 861-7979
(207) 487-5626
Mailing address
30 W CONCOURSE, WATERVILLE, ME 04901-6007
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH50001163
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007587
OTHER ID NUMBER
—
Enumeration date
12/13/2006
Last updated
07/31/2007
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