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General NPI Number Information
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NPI Number | 1083277933
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Entity Type | Individual
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Provider Name | STEPHEN MAKI RPH
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Gender | Male
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 148 MAIN ST
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City | JAY
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State | ME
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Zip | 04239-1506
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Country | US
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Telephone | 207-897-9080
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Fax | 207-897-9082
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Provider Business Mailing Address
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Address Line | PO BOX 343
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City | JAY
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State | ME
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Zip | 04239-0343
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Country | US
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Telephone | 207-778-8969
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Fax | 207-897-9082
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PR4626
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License Number State | ME
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