Mt Blue Drug

LBN: Mt Blue Drug Inc
Mt Blue Drug is an health care organization with primary practice located at 624 Wilton Rd , Farmington ME 04938-6138. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Mt Blue Drug Inc can be contacted via phone (207) 778-5419, or through Holland, Kevin R via phone (207) 474-3393.

Contact Information

Primary practice address
624 Wilton Rd Farmington ME 04938-6138
Phone: (207) 778-5419
Fax: (207) 778-5983
Website:
Map and Directions
Authorized official contact:
Name: Holland, Kevin R RPH
Phone: (207) 474-3393

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PH50001429 Maine
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1568759058
LBN Legal business name Mt Blue Drug Inc
DBA Doing business as Mt Blue Drug
Authorized official Holland, Kevin R RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jul 5th, 2011
Last updated Jun 13th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568759058 NPPES
Other 2131060 PK
MEDICAID 169480000 PK

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