Healthcare Provider Details

I. General information

NPI: 1043306939
Provider Name (Legal Business Name): CITY PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 ACADEMY ST
PRESQUE ISLE ME
04769-3101
US

IV. Provider business mailing address

159 ACADEMY ST
PRESQUE ISLE ME
04769-3101
US

V. Phone/Fax

Practice location:
  • Phone: 207-764-4424
  • Fax: 207-764-4425
Mailing address:
  • Phone: 207-764-4424
  • Fax: 207-764-4425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH50001534
License Number StateME

VIII. Authorized Official

Name: DOUGLAS TALBOT
Title or Position: PRESIDENT
Credential:
Phone: 207-764-4424