MEDICARE: PHARMACY ACQUISTION INC

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	3336L0003X	Long Term Care Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy
4	3336C0003X	Community/Retail Pharmacy	PH50001295	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2001244	OTHER	NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699710806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY ACQUISTION INC

Provider Business Mailing Address
First Line	:	58 PARK ST
Second Line	:
City	:	ROCKLAND
State	:	ME
Zip	:	04841-2862
Country	:	US
Telephone Number	:	207-594-5131
Fax Number	:	207-594-4428

Provider Business Practice Location Address
First Line	:	58 PARK ST
Second Line	:
City	:	ROCKLAND
State	:	ME
Zip	:	04841-2862
Country	:	US
Telephone Number	:	207-594-5131
Fax Number	:	207-594-4428

Authorized Official
Title or Position	:	VP MANG
Name	:	JOELLA MARRINER
Credential	:
Telephone Number	:	207-594-5131

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	01/31/2010

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Directions to “PHARMACY ACQUISTION INC ” Practice Location

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