Healthcare Provider Details

I. General information

NPI: 1720990831
Provider Name (Legal Business Name): ANNE MARIE ANDRLE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 BRAMHALL ST
PORTLAND ME
04102-3134
US

IV. Provider business mailing address

47 LORD RD
BUXTON ME
04093-6215
US

V. Phone/Fax

Practice location:
  • Phone: 207-662-3273
  • Fax:
Mailing address:
  • Phone: 207-450-3491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0206X
TaxonomyCardiology Pharmacist
License NumberPR5009
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: