Organization
NORTHERN MAINE MEDICAL CENTER
Active
Organization
NORTHERN MAINE MEDICAL CENTER
Active
Other names
ST JOHN VALLEY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AARON TEACHOUT (CFO)
(207) 834-1820
Entity
Organization
Contact information
Practice address
182 MARKET ST, STE 2, FORT KENT, ME 04743
(207) 834-2880
(207) 834-2882
Mailing address
PO BOX 189, FORT KENT, ME 04743
(207) 834-2880
(207) 834-2882
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH50001216
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2037573
PK
—
05
—
424260000
—
ME
Enumeration date
08/13/2005
Last updated
03/25/2025
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