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Organization

M DRUG LLC

Active
Other names
NORTHERN LIGHT PHARMACY RIVERSIDE
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW MARSTON PHARMD (DIRECTOR OF PHARMACY)
(207) 275-3239
Entity
Organization

Contact information

Practice address
417 STATE ST STE 130, BANGOR, ME 04401-6630
(207) 973-8888
(207) 973-8891
Mailing address
PO BOX 1779, BANGOR, ME 04402-1779
(207) 973-8888
(207) 973-8891

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PH50001488
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1407951676
ME
01
2125120
PK
Enumeration date
09/13/2006
Last updated
10/10/2019
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