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General NPI Number Information
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NPI Number | 1700305273
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Entity Type | Individual
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Provider Name | HARVARD SAMUEL BRIDGES
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Gender | Male
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 09/15/2017
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Provider Practice Location Address
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Address Line | 75 MAIN ST
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City | BUCKSPORT
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State | ME
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Zip | 04416-4025
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Country | US
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Telephone | 207-463-7030
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Fax |
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Provider Business Mailing Address
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Address Line | 333 STATE ST APT A
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City | BANGOR
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State | ME
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Zip | 04401-5532
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Country | US
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Telephone | 207-479-4477
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PR46815
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License Number State | ME
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