Individual
AUDREY SANICOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 RUNNING HILL RD, SOUTH PORTLAND, ME 04106-3258
(207) 871-0911
Mailing address
200 RUNNING HILL RD, SOUTH PORTLAND, ME 04106-3258
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR13005
ME
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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