Healthcare Provider Details
I. General information
NPI: 1538156807
Provider Name (Legal Business Name): COMMUNITY PHARMACIES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2005
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
365 MAIN ST
GORHAM ME
04038-1309
US
IV. Provider business mailing address
PO BOX 528
AUGUSTA ME
04332-0528
US
V. Phone/Fax
- Phone: 207-839-7892
- Fax: 207-839-8058
- Phone: 207-621-0698
- Fax: 207-622-0952
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PH50001405 |
| License Number State | ME |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 1538156807 |
| Identifier Type | MEDICAID |
| Identifier State | ME |
| Identifier Issuer | |
| # 2 | |
| Identifier | 2126873 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | PK |
VIII. Authorized Official
Name:
MICHELLE
CHAMBERLAND
Title or Position: DME OPS & PHARMACY SERVICES MANAGER
Credential:
Phone: 207-621-0698