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General NPI Number Information
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NPI Number | 1780685628
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Entity Type | Organization
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Legal Business Name | PIN RX, LLC
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 31 WABANAKI WAY
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City | INDIAN ISLAND
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State | ME
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Zip | 04468-1252
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Country | US
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Telephone | 866-746-7985
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Fax | 877-746-7985
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Provider Business Mailing Address
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Address Line | 31 WABANAKI WAY
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City | INDIAN ISLAND
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State | ME
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Zip | 04468-1252
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Country | US
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Telephone | 866-746-7985
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Fax | 877-746-7985
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK A. CHAVAREE
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Credential | J.D.
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Telephone | 207-817-7324
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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 |
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License Number State | ME
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