Healthcare Provider Details

I. General information

NPI: 1538070446
Provider Name (Legal Business Name): ANNA KLECKEROVA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 MAINE ST
BRUNSWICK ME
04011-2007
US

IV. Provider business mailing address

156 MAINE ST
BRUNSWICK ME
04011-2007
US

V. Phone/Fax

Practice location:
  • Phone: 207-729-8100
  • Fax: 207-729-1355
Mailing address:
  • Phone: 207-729-1355
  • Fax: 207-729-1355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR73387
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: