MEDICARE: ATHER FAREEDUDDIN MOHAMMED 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	PR5180	ME

General Provider Information

NPI Number	:	1700198686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATHER FAREEDUDDIN MOHAMMED RPH

Provider Business Mailing Address
First Line	:	2007 N BELFAST AVE
Second Line	:
City	:	AUGUSTA
State	:	ME
Zip	:	04330-4363
Country	:	US
Telephone Number	:	207-622-6278
Fax Number	:	207-622-0721

Provider Business Practice Location Address
First Line	:	2007 N BELFAST AVE
Second Line	:
City	:	AUGUSTA
State	:	ME
Zip	:	04330-4363
Country	:	US
Telephone Number	:	207-622-6278
Fax Number	:	207-621-0721

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

Provider Enumeration Date	:	07/08/2010
Last Update Date	:	07/08/2010

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