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NPI Code Detail

MEDICARE: MRS. AMANDA JEAN CRAIG R.PH.

MEDICARE:  MRS. AMANDA JEAN CRAIG  R.PH.
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
1183500000XPharmacistPR4266ME

General Provider Information

NPI Number : 1821099193
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA JEAN CRAIG R.PH.
Provider Business Mailing Address
First Line : 47 KENDALL HEAD RD
Second Line :
City : EASTPORT
State : ME
Zip : 04631-3615
Country : US
Telephone Number : 207-853-2892
Fax Number :
Provider Business Practice Location Address
First Line : 1 SIDE RD
Second Line :
City : PLEASANT POINT
State : ME
Zip : 04667-4128
Country : US
Telephone Number : 207-853-0644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 07/08/2007

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Directions to “ MRS. AMANDA JEAN CRAIG R.PH.” Practice Location

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