Healthcare Provider Details

I. General information

NPI: 1245273846
Provider Name (Legal Business Name): ROBERT CRAIG FALK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 VERANDA ST MARTIN'S POINT HEALTH CARE
PORTLAND ME
04103-5545
US

IV. Provider business mailing address

15 SPOONDRIFT LN
CAPE ELIZABETH ME
04107-2934
US

V. Phone/Fax

Practice location:
  • Phone: 207-791-3746
  • Fax:
Mailing address:
  • Phone: 207-799-2192
  • Fax: 207-828-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR4551
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: