Organization
SHIRETOWN PHARMACY LLC
Active
Other names
Shiretown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES OUELLETTE (OWNER)
(207) 834-2880
Entity
Organization
Contact information
Practice address
101 MILITARY ST, HOULTON, ME 04730-2511
(207) 532-5980
(207) 532-5981
Mailing address
PO BOX 189, FORT KENT, ME 04743-0189
(207) 532-5980
(207) 532-5981
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH50001446
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962775726
—
ME
01
—
2133708
PK
—
Enumeration date
02/09/2012
Last updated
12/06/2013
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