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General NPI Number Information
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NPI Number | 1487067997
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Entity Type | Organization
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Legal Business Name | SEASIDE PHARMACY
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 59 SCHOOL STREET
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City | STONINGTON
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State | ME
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Zip | 04681
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Country | US
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Telephone | 207-367-2575
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Fax | 207-367-2570
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Provider Business Mailing Address
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Address Line | PO BOX 649 59 SCHOOL STREET
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City | STONINGTON
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State | ME
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Zip | 04681-0649
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Country | US
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Telephone | 207-367-2575
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Fax | 207-367-2570
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Authorized Official
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Title or Position | VICE-PRESIDENT, CFO
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Name | DOUGLAS R EDINGER
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Credential | R.PH.
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Telephone | 207-367-2575
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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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