Healthcare Provider Details

I. General information

NPI: 1447317821
Provider Name (Legal Business Name): PATTEN DRUG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 11/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MAIN ST
PATTEN ME
04765-3151
US

IV. Provider business mailing address

PO BOX 675
PATTEN ME
04765-0675
US

V. Phone/Fax

Practice location:
  • Phone: 207-528-2244
  • Fax: 207-528-2243
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH50000115
License Number StateME

VIII. Authorized Official

Name: JOEL FITZPATRICK
Title or Position: PRES
Credential: RPH
Phone: 207-528-2244