Organization
M DRUG LLC
Active
Other names
NORTHERN LIGHT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MARSTON PHARMD (DIRECTOR OF PHARMACY)
(207) 275-3239
Entity
Organization
Contact information
Practice address
401 N MAIN ST STE A&B, BREWER, ME 04412-1873
(207) 275-3300
(207) 275-3310
Mailing address
PO BOX 1779, BANGOR, ME 04402-1779
(207) 275-3261
(207) 561-4804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148485
PK
—
Enumeration date
10/31/2014
Last updated
10/10/2019
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