MEDICARE: CRAIG VESELY PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PR5638	ME

General Provider Information

NPI Number	:	1093092363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG VESELY PHARM.D.

Provider Business Mailing Address
First Line	:	91 AUBURN ST
Second Line	:	OSCO PHARMACY
City	:	PORTLAND
State	:	ME
Zip	:	04103-6008
Country	:	US
Telephone Number	:	207-797-0536
Fax Number	:	207-797-2439

Provider Business Practice Location Address
First Line	:	91 AUBURN ST
Second Line	:	OSCO PHARMACY
City	:	PORTLAND
State	:	ME
Zip	:	04103-6008
Country	:	US
Telephone Number	:	207-797-0536
Fax Number	:	207-797-2439

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2011
Last Update Date	:	11/14/2011

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Directions to “ CRAIG VESELY PHARM.D.” Practice Location

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