Western Maine Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH50001437 Issued in ME

Legal business name

WESTERN MAINE PHARMACY INC

Practice address

119 Main St
Kingfield, ME 04947-4229

Phone

(207) 265-8020

Fax

(207) 265-8022

NPI assigned

Sep 20, 2011

Organization subpart

No

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

Authorized official

Name

Audrey Gould

Title

President

Phone

(207) 265-8020

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Western Maine Pharmacy, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1306129085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64",
            "city": "KINGFIELD",
            "state": "ME",
            "postal_code": "049470064",
            "telephone_number": "207-265-8020",
            "fax_number": "207-265-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 MAIN ST",
            "city": "KINGFIELD",
            "state": "ME",
            "postal_code": "049474229",
            "telephone_number": "207-265-8020",
            "fax_number": "207-265-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MAINE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-265-8020"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ME",
            "license": "PH50001437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131979",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Maine Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Western Maine Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Dexter
• Millicent Clapp
• Paula Jayne Norcott, CLC, CBE, LD, PPD
• Karol Shaw
• Garrett F Smith, PA-C

• All providers in Kingfield, ME
• Community/Retail Pharmacy in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.