Organization
WALTZ PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN JACOBS RPH (PRESIDENT)
(207) 230-1053
Entity
Organization
Contact information
Practice address
1 BELMONT AVE # D-1, BELFAST, ME 04915-6859
(207) 338-1722
(207) 338-6843
Mailing address
PO BOX 130, CAMDEN, ME 04843-0130
(207) 230-1053
(207) 230-0039
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH50001083
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007284
NABP#
ME
Enumeration date
12/05/2006
Last updated
08/22/2020
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