Healthcare Provider Details

I. General information

NPI: 1013732700
Provider Name (Legal Business Name): NATALYA GIROUX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 ROOSEVELT TRL
WINDHAM ME
04062-5269
US

IV. Provider business mailing address

PO BOX 453
GORHAM ME
04038-0453
US

V. Phone/Fax

Practice location:
  • Phone: 207-893-2562
  • Fax:
Mailing address:
  • Phone: 712-635-4105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR73114
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: