Healthcare Provider Details

I. General information

NPI: 1225124308
Provider Name (Legal Business Name): ALYNE NEWELL ANDERSON PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VA CTR 119
AUGUSTA ME
04330-6719
US

IV. Provider business mailing address

PO BOX 236
COOPERS MILLS ME
04341-0236
US

V. Phone/Fax

Practice location:
  • Phone: 207-623-8411
  • Fax: 207-623-5731
Mailing address:
  • Phone: 207-623-8411
  • Fax: 207-623-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number21158
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: