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NPI Code Detail

MEDICARE: DARLENE MARIE LEISENTRITT RPH

MEDICARE:   DARLENE MARIE LEISENTRITT  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
1183500000XPharmacist4084ME
2183500000XPharmacistPR4084ME

General Provider Information

NPI Number : 1558857953
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARLENE MARIE LEISENTRITT RPH
Provider Business Mailing Address
First Line : 40 WORCESTER WAY
Second Line :
City : LINCOLN
State : ME
Zip : 04457-4427
Country : US
Telephone Number : 207-403-3629
Fax Number : 207-794-0220
Provider Business Practice Location Address
First Line : 250 W BROADWAY
Second Line :
City : LINCOLN
State : ME
Zip : 04457-4006
Country : US
Telephone Number : 207-794-2055
Fax Number : 207-794-0220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2018
Last Update Date : 07/09/2018

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Directions to “ DARLENE MARIE LEISENTRITT RPH” Practice Location

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