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General NPI Number Information
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NPI Number | 1811489156
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Entity Type | Individual
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Provider Name | SANDRA BARTLETT PHARMD, BCPS, BCCCP
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Gender | Female
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Dates
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Enumeration Date | 06/02/2018
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Last Update Date | 06/02/2018
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Provider Practice Location Address
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Address Line | 360 BROADWAY
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City | BANGOR
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State | ME
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Zip | 04401-3979
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Country | US
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Telephone | 207-907-1612
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Fax |
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Provider Business Mailing Address
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Address Line | 8 RIVERBEND DR
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City | GLENBURN
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State | ME
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Zip | 04401-1146
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Country | US
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Telephone | 785-312-1749
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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 | 1835C0205X
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Taxonomy Name | Critical Care Pharmacist
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License Number | PR13175
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | PR13175
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License Number State | ME
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