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General NPI Number Information
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NPI Number | 1245229749
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Entity Type | Organization
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Legal Business Name | FAIRFIELD PHARMACY
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 66 WESTERN AVE
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City | FAIRFIELD
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State | ME
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Zip | 04937-1337
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Country | US
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Telephone | 207-453-4411
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Fax | 207-453-6612
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Provider Business Mailing Address
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Address Line | 66 WESTERN AVE
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City | FAIRFIELD
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State | ME
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Zip | 04937-1337
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Country | US
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Telephone | 207-453-4411
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Fax | 207-453-6612
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Authorized Official
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Title or Position | PHARMACIST - OWNER
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Name | MR. SHANE SAVAGE
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Credential | RPH
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Telephone | 207-453-4411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH50001197
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License Number State | ME
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