Healthcare Provider Details

I. General information

NPI: 1396961041
Provider Name (Legal Business Name): DEAN TSAMPARLIS R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 ROLLINGWOOD RD
ELIOT ME
03903-1524
US

IV. Provider business mailing address

112 ROLLINGWOOD RD
ELIOT ME
03903-1524
US

V. Phone/Fax

Practice location:
  • Phone: 207-439-8323
  • Fax:
Mailing address:
  • Phone: 207-439-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2496
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: