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NPI Code Detail

MEDICARE: DR. JAMIE L/ CRONIN PHARMD

MEDICARE: DR. JAMIE L/ CRONIN 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
11835P1200XPharmacotherapy PharmacistPR4024ME

General Provider Information

NPI Number : 1275539397
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMIE L/ CRONIN PHARMD
Provider Business Mailing Address
First Line : 125 YANKEE AVE
Second Line :
City : BANGOR
State : ME
Zip : 04401-2761
Country : US
Telephone Number : 207-945-6439
Fax Number :
Provider Business Practice Location Address
First Line : 489 STATE ST
Second Line :
City : BANGOR
State : ME
Zip : 04401-6616
Country : US
Telephone Number : 207-973-8756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 07/08/2007

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