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NPI Code Detail

MEDICARE: KENNEBEC PHARMACY & HOME CARE, LLC

MEDICARE: KENNEBEC PHARMACY & HOME CARE, LLC
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1790368603
Entity Type Code : Organization
Provider Name (Legal Business Name) : KENNEBEC PHARMACY & HOME CARE, LLC
Provider Business Mailing Address
First Line : 219 MOUNT AUBURN AVE STE B
Second Line :
City : AUBURN
State : ME
Zip : 04210-8521
Country : US
Telephone Number : 207-626-2726
Fax Number : 207-626-8163
Provider Business Practice Location Address
First Line : 219 MOUNT AUBURN AVE SUITE B
Second Line :
City : AUBURN
State : ME
Zip : 04210-8521
Country : US
Telephone Number : 207-626-2120
Fax Number : 207-626-8163
Authorized Official
Title or Position : CONTROLLER
Name : TED NATHAN TREBILCOCK
Credential :
Telephone Number : 207-626-2726
Provider Enumeration Date : 04/29/2021
Last Update Date : 02/23/2026

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Directions to “KENNEBEC PHARMACY & HOME CARE, LLC ” Practice Location

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