MEDICARE: DR. ANDREW BAYRER CLOSSON PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PR5225	ME

General Provider Information

NPI Number	:	1083932339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW BAYRER CLOSSON PHARMD

Provider Business Mailing Address
First Line	:	33 DEPOT RD
Second Line	:
City	:	FALMOUTH
State	:	ME
Zip	:	04105-1715
Country	:	US
Telephone Number	:	207-781-4414
Fax Number	:	207-781-3097

Provider Business Practice Location Address
First Line	:	33 DEPOT RD
Second Line	:
City	:	FALMOUTH
State	:	ME
Zip	:	04105-1715
Country	:	US
Telephone Number	:	207-781-4414
Fax Number	:	207-781-3097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2010
Last Update Date	:	05/11/2010

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