MEDICARE: JACOB PAUL FELTON 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	PR27919	ME
2	183500000X	Pharmacist	14693	NE

General Provider Information

NPI Number	:	1699262998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB PAUL FELTON PHARMD

Provider Business Mailing Address
First Line	:	6 BRIDLE PATH WAY
Second Line	:
City	:	CAPE ELIZABETH
State	:	ME
Zip	:	04107-1802
Country	:	US
Telephone Number	:	402-301-7136
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 DONALD B DEAN DR STE 3
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-3372
Country	:	US
Telephone Number	:	207-910-0771
Fax Number	:	207-910-0772

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

Provider Enumeration Date	:	04/23/2018
Last Update Date	:	11/06/2025

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Directions to “ JACOB PAUL FELTON PHARMD” Practice Location

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