Individual
ELLEN BURNHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40 MAIN AVE, GARDINER, ME 04345-2176
(207) 582-3771
(207) 582-4089
Mailing address
5 FIELDSTONE DR, AUGUSTA, ME 04330-8254
(207) 576-1638
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR4766
ME
Other
Enumeration date
11/08/2020
Last updated
11/08/2020
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