| NPI | 1184657439 |
|---|---|
| Doing Business As | SUPER G PHARMACY 387 |
| Entity Type | Organization |
| Authorized Contact | IRA KRESS President 207-885-7454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: DE A30000654) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: DE A30000654) |
| 333600000X Pharmacy (Licence: DE A30000654) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-03-06 |