Organization
WALTZ PHARMACY, INC
Active
Other names
WALTZ HOME MEDICAL SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN JACOBS RPH (PRESIDENT)
(866) 415-1954
Entity
Organization
Contact information
Practice address
83 ELM ST, CAMDEN, ME 04843-1942
(207) 236-2240
(207) 236-9489
Mailing address
PO BOX 130, CAMDEN, ME 04843-0130
(207) 236-2240
(207) 236-9489
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003012
ANTHEM BLUE CROSS ID#
ME
01
—
048613
BLUE CROSS
ME
05
—
101460005
—
ME
Enumeration date
12/18/2006
Last updated
11/11/2008
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