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NPI Code Detail

MEDICARE: LISBETH CC AVAKIAN PHARMD

MEDICARE: LISBETH CC AVAKIAN 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
1183500000XPharmacistPR5359ME

General Provider Information

NPI Number : 1790261477
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISBETH CC AVAKIAN PHARMD
Provider Business Mailing 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
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 : 07/16/2018
Last Update Date : 07/16/2018

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Directions to “ LISBETH CC AVAKIAN PHARMD” Practice Location

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