=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699080275
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NANA AFARI RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2010
-----------------------------------------------------
Last Update Date | 11/11/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23 SNELL HILL RD
-----------------------------------------------------
City | TURNER
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04282-4400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-225-5146
-----------------------------------------------------
Fax | 207-225-5170
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23 SNELL HILL RD
-----------------------------------------------------
City | TURNER
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04282-4400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-225-5146
-----------------------------------------------------
Fax | 207-225-5170
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PR5550
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------