Organization
CENTRAL MAINE MEDICAL CENTER
Active
Other names
CMMC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN CHUPKA DOCTORATE (PHARMACY MANAGER)
(207) 795-8106
Entity
Organization
Contact information
Practice address
12 HIGH ST, LEWISTON, ME 04240-7676
(207) 795-7177
(207) 795-7552
Mailing address
CMMC PHARMACY, 300 MAIN STREET, LEWISTON, ME 04240
(207) 795-7177
(207) 795-7552
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH50001491
ME
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861433765
—
ME
01
—
2037588
PK
—
Enumeration date
06/10/2006
Last updated
07/14/2016
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