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General NPI Number Information
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NPI Number | 1134189186
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Entity Type | Organization
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Legal Business Name | MARTINS POINT HEALTH CARE INC
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 901 WASHINGTON AVE
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City | PORTLAND
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State | ME
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Zip | 04103-2737
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Country | US
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Telephone | 207-774-5801
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Fax | 207-828-2483
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Provider Business Mailing Address
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Address Line | 331 VERANDA ST
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City | PORTLAND
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State | ME
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Zip | 04103-5545
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Country | US
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Telephone | 207-774-5801
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Fax | 207-828-2495
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | ROBERT FALK
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Credential |
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Telephone | 207-791-3746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | PH50001370
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License Number State | ME
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