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General NPI Number Information
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NPI Number | 1659476836
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Entity Type | Organization
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Legal Business Name | AFFILIATED PHARMACY SERVICES
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 405 N MAIN ST NORTH MAIN ST SHOPPING CTR
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City | BREWER
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State | ME
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Zip | 04412-1877
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Country | US
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Telephone | 207-989-2424
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Fax | 207-989-6060
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Provider Business Mailing Address
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Address Line | 405 N MAIN ST NORTH MAIN ST SHOPPING CTR
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City | BREWER
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State | ME
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Zip | 04412-1877
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENOR IS ANALYST
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Name | DAMON WILSON
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Credential |
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Telephone | 207-973-6684
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH50001105
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License Number State | ME
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