Organization
HANNAFORD BROS CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VAIL (PRESIDENT AND MANAGER)
(207) 885-7454
Entity
Organization
Contact information
Practice address
50 PIGEON HILL RD, MECHANIC FALLS, ME 04256
(207) 998-2650
(207) 998-2670
Mailing address
PO BOX 1000, PORTLAND, ME 04104-5005
(207) 885-7454
(704) 645-6531
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2178002
PK
—
Enumeration date
05/17/2018
Last updated
08/01/2018
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