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NPI Code Detail

MEDICARE: NIKOLAS MITSOPOULOS PHARMD, RPH

MEDICARE: NIKOLAS MITSOPOULOS PHARMD, RPH
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
1183500000XPharmacistPR6081ME

General Provider Information

NPI Number : 1336420355
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKOLAS MITSOPOULOS PHARMD, RPH
Provider Business Mailing Address
First Line : 11 STATE RD
Second Line :
City : BATH
State : ME
Zip : 04530-6014
Country : US
Telephone Number : 207-443-1786
Fax Number :
Provider Business Practice Location Address
First Line : 11 STATE RD
Second Line :
City : BATH
State : ME
Zip : 04530-6014
Country : US
Telephone Number : 207-443-1786
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2011
Last Update Date : 09/03/2011

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Directions to “ NIKOLAS MITSOPOULOS PHARMD, RPH” Practice Location

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