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General NPI Number Information
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NPI Number | 1821099193
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Entity Type | Individual
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Provider Name | AMANDA JEAN CRAIG R.PH.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 SIDE RD
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City | PLEASANT POINT
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State | ME
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Zip | 04667-4128
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Country | US
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Telephone | 207-853-0644
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Fax |
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Provider Business Mailing Address
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Address Line | 47 KENDALL HEAD RD
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City | EASTPORT
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State | ME
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Zip | 04631-3615
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Country | US
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Telephone | 207-853-2892
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PR4266
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License Number State | ME
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