Healthcare Provider Details

I. General information

NPI: 1336075985
Provider Name (Legal Business Name): JACK FINNEY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 EDISON DR
AUGUSTA ME
04330-6037
US

IV. Provider business mailing address

12 EDISON DR
AUGUSTA ME
04330-6037
US

V. Phone/Fax

Practice location:
  • Phone: 940-395-6215
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835N0905X
TaxonomyNuclear Pharmacist
License NumberPR70864
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: