Edward G Bosshart, PHARMD
Individual provider Active NPI Pharmacist · Brewer, ME
NPI 1104159516 · NPPES record last updated Sep 16, 2009
Key facts
- NPI
- 1104159516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PR5523 (ME)
- Practice address
- 437 Wilson St
Brewer, ME 04412-1414 - Phone
- (207) 991-9679
- NPI assigned
- Sep 16, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR5523 | ME | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PR5523 | ME | Yes |
Addresses
Primary practice location
437 Wilson St
Brewer, ME 04412-1414
Mailing address
437 Wilson St
Brewer, ME 04412-1414
Other providers in Brewer, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.