Organization
M DRUG LLC
Active
Organization
M DRUG LLC
Active
Other names
NORTHERN LIGHT PHARMACY WESTGATE
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MARSTON PHARMD (DIRECTOR OF PHARMACY)
(207) 275-3256
Entity
Organization
Contact information
Practice address
915 UNION ST STE 7, BANGOR, ME 04401-8604
(207) 973-6788
(207) 973-6782
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
PH50001490
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427153600
—
ME
01
—
2125121
PK
—
Enumeration date
09/13/2006
Last updated
10/10/2019
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