| NPI | 1881961589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL IVAN BOUDREAU Staff Pharmacist 207-669-3005 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: ME PR4615) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2011-11-23 |