Healthcare Provider Details

I. General information

NPI: 1790661254
Provider Name (Legal Business Name): EMILY TERRANOVA PHARMD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 N MAIN ST
PITTSFIELD ME
04967-3799
US

IV. Provider business mailing address

PO BOX 251
MANCHESTER ME
04351-0251
US

V. Phone/Fax

Practice location:
  • Phone: 207-487-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number033.0135793
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR72996
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: