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General NPI Number Information
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NPI Number | 1205399011
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Entity Type | Organization
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Legal Business Name | COVETRUS NORTH AMERICA, LLC
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 12 MOUNTFORT ST
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City | PORTLAND
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State | ME
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Zip | 04101-4307
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Country | US
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Telephone | 207-274-6035
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Fax |
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Provider Business Mailing Address
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Address Line | 7 CUSTOM HOUSE ST STE 5
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City | PORTLAND
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State | ME
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Zip | 04101-4185
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Country | US
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Telephone | 888-280-2221
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Fax |
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Authorized Official
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Title or Position | LICENSING AND CREDENTIALING ANALYST
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Name | SUMMER ROPER
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Credential |
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Telephone | 623-340-9721
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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