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NPI Code Detail

MEDICARE: MR. TUAN M LE PHARM.D

MEDICARE: MR. TUAN M LE PHARM.D
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
1183500000XPharmacistPR5100ME

General Provider Information

NPI Number : 1225343924
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TUAN M LE PHARM.D
Provider Business Mailing Address
First Line : 180 E GRAND AVE APT 4
Second Line :
City : OLD ORCHARD BEACH
State : ME
Zip : 04064-3063
Country : US
Telephone Number : 585-978-0746
Fax Number :
Provider Business Practice Location Address
First Line : 600 US ROUTE 1
Second Line :
City : SCARBOROUGH
State : ME
Zip : 04074-9776
Country : US
Telephone Number : 207-885-1515
Fax Number : 207-885-0732
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2010
Last Update Date : 08/18/2010

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