| NPI | 1649281155 |
|---|---|
| Doing Business As | NORTHERN LIGHT PHARMACY STATE STREET |
| Entity Type | Organization |
| Authorized Contact | MATTHEW MARSTON Director Of Pharmacy 207-275-3239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: ME PH50001487) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2019-10-10 |