Organization
MAINEHEALTH
Active
Other names
The Pharmacy at Pen Bay Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY WADE (REGIONAL CHIEF OPERATING OFFICER)
(207) 563-4597
Entity
Organization
Contact information
Practice address
6 GLEN COVE DR, ROCKPORT, ME 04856-4273
(207) 921-8585
Mailing address
6 GLEN COVE DR, ROCKPORT, ME 04856-4273
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH50001080
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2037448
PK
—
Enumeration date
08/21/2018
Last updated
03/01/2019
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