MEDICARE: MR. MARK EDWARD STRICKLAND RPH

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	4237	ME
2	183500000X	Pharmacist	0330003780	VT
3	183500000X	Pharmacist	R2153	NH
4	183500000X	Pharmacist	PH22593	MA

General Provider Information

NPI Number	:	1164792594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK EDWARD STRICKLAND RPH

Provider Business Mailing Address
First Line	:	14 PLYMOUTH DR
Second Line	:
City	:	SACO
State	:	ME
Zip	:	04072-1734
Country	:	US
Telephone Number	:	207-282-5591
Fax Number	:

Provider Business Practice Location Address
First Line	:	91 AUBURN ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-6008
Country	:	US
Telephone Number	:	207-797-0536
Fax Number	:

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

Provider Enumeration Date	:	01/02/2012
Last Update Date	:	01/02/2012

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