=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184975823
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAIN PAUL AINSLIE DOCTOR OF PHARMACY
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2012
-----------------------------------------------------
Last Update Date | 09/20/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 75 GRENIER RD
-----------------------------------------------------
City | VASSALBORO
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04989-4022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-441-9692
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 75 GRENIER RD
-----------------------------------------------------
City | VASSALBORO
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04989-4022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-441-9692
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PR5465
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------