Dominique, Mark

Dominique, Mark is an individual health care provider with primary practice located at 65 Western Ave Rite Aid, Hampden ME 04444-1423. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Pharmacy Service Providers / Pharmacist. Pharmacy Service Providers / Pharmacist is his primary health care specialty. Dominique, Mark can be contacted via phone (207) 862-4900.

Contact Information

Primary practice address
65 Western Ave Rite Aid Hampden ME 04444-1423
Phone: (207) 862-4900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LC12200 Maine
Pharmacy Service Providers / Pharmacist 183500000X PR6065 Maine

Profile Details

NPI number 1831423201
LBN Legal business name Dominique, Mark
Credentials PHARM.D, LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2009
Last updated Jul 17th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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