Healthcare Provider Details

I. General information

NPI: 1578935748
Provider Name (Legal Business Name): YORK HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 02/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 US ROUTE 1 DEPARTMENT OF PHARMACY
YORK ME
03909-1636
US

IV. Provider business mailing address

15 HOSPITAL DR DEPARTMENT OF PHARMACY
YORK ME
03909-1011
US

V. Phone/Fax

Practice location:
  • Phone: 207-363-4321
  • Fax: 207-351-2308
Mailing address:
  • Phone: 207-363-4321
  • Fax: 207-351-2308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH50001537
License Number StateME

VIII. Authorized Official

Name: JUD KNOX
Title or Position: CEO
Credential:
Phone: 207-363-4321