Healthcare Provider Details

I. General information

NPI: 1548549082
Provider Name (Legal Business Name): CORRADOS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 MAIN ST
CORINTH ME
04427-3272
US

IV. Provider business mailing address

352 MAIN ST
CORINTH ME
04427-3272
US

V. Phone/Fax

Practice location:
  • Phone: 207-285-7778
  • Fax: 207-285-7771
Mailing address:
  • Phone: 207-285-7778
  • Fax: 207-285-7771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH50001434
License Number StateME

VIII. Authorized Official

Name: PAUL CORRADO
Title or Position: PRESIDENT
Credential:
Phone: 207-518-3356