Healthcare Provider Details

I. General information

NPI: 1467372565
Provider Name (Legal Business Name): BRYAN CARPENTER CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 DESERT BROOK DR
LYMAN ME
04002-7372
US

IV. Provider business mailing address

34 DESERT BROOK DR
LYMAN ME
04002-7372
US

V. Phone/Fax

Practice location:
  • Phone: 207-229-2244
  • Fax:
Mailing address:
  • Phone: 207-229-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberPT60018366
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: