Individual
VENKATESHWAR BASANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
50 BOULDER WAY, BIDDEFORD, ME 04005-9442
(207) 286-9562
(207) 286-9576
Mailing address
15 TAMARACK LN, SCARBOROUGH, ME 04074-9844
(207) 671-5939
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR5718
ME
Other
Enumeration date
07/21/2018
Last updated
07/21/2018
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