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General NPI Number Information
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NPI Number | 1104528363
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Entity Type | Organization
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Legal Business Name | M DRUG LLC
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 161 HIGH ST
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City | ELLSWORTH
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State | ME
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Zip | 04605-1713
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Country | US
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Telephone | 207-910-4156
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Fax |
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Provider Business Mailing Address
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Address Line | 43 WHITING HILL RD
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City | BREWER
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State | ME
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Zip | 04412-1005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF PHARMACY OFFICER
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Name | MATTHEW JAY MARSTON
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Credential | PHARM-D
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Telephone | 207-275-3239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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