Individual
WAYNE D BOURQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1 VA CTR, AUGUSTA, ME 04330-6719
(207) 623-8411
(207) 621-4843
Mailing address
1 VA CTR, AUGUSTA, ME 04330-6719
(207) 623-8411
(207) 621-4843
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
21756
MA
183500000X
Pharmacist
Primary
PH4865
ME
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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