NPIMap

Organization Active NPI

M Drug LLC

Doing business as Northern Light Pharmacy Downeast

  • Community/Retail Pharmacy
  • Ellsworth, ME
National Provider Identifier
1104528363
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
M DRUG LLC
Doing business as
Northern Light Pharmacy Downeast
Practice address
161 High St
Ellsworth, ME 04605-1713
Phone
(207) 910-4156
NPI assigned
Mar 21, 2023
Last updated
Mar 21, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
EASTERN MAINE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matthew Jay Marston, PHARM-D
Title
Chief Pharmacy Officer
Phone
(207) 275-3239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

161 High St
Ellsworth, ME 04605-1713

Mailing address

43 Whiting Hill Rd
Brewer, ME 04412-1005

Other names 1

  • Northern Light Pharmacy Downeast Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130129000000 ME Part B Supplier - Mass Immunization (Roster Biller Only) 6305037367 8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bangor, ME; Brewer, ME; Ellsworth, ME; Portland, ME

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
M Drug LLC3 organizations share this tax ID, including this one
Part of
Eastern Maine Medical C

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

161 High St
Ellsworth, ME 04605
Phone (207) 910-4146

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1104528363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 HIGH ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051713",
            "telephone_number": "207-910-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M DRUG LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTERN MAINE MEDICAL CENTER",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "MARSTON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "207-275-3239",
        "authorized_official_credential": "PHARM-D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Light Pharmacy Downeast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellsworth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.