Organization
SOUTH BERWICK PHARMACY SEACOAST COMPOUNDING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATE KENNEY HANSEN (OWNER)
(207) 384-2772
Entity
Organization
Contact information
Practice address
289 MAIN ST, SOUTH BERWICK, ME 03908-1543
(207) 384-2772
Mailing address
289 MAIN ST, SOUTH BERWICK, ME 03908-1543
(207) 384-2772
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH50001453
ME
3336C0004X
Compounding Pharmacy
PH50001453
ME
Other
Enumeration date
05/03/2012
Last updated
09/13/2021
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