NPIMap

Organization Active NPI

Presque Isle Pharmacy Co., LLC

Doing business as Presque Isle Pharmacy

  • Long Term Care Pharmacy
  • Presque Isle, ME
National Provider Identifier
1417662255
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PRESQUE ISLE PHARMACY CO., LLC
Doing business as
Presque Isle Pharmacy
Practice address
797 Main St
Presque Isle, ME 04769-2201
Phone
(207) 760-9100
Fax
(207) 760-9191
NPI assigned
Jan 17, 2023
Last updated
Feb 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Kylie M Fuller
Title
Pharmacy Manager
Phone
(207) 760-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

797 Main St
Presque Isle, ME 04769-2201

Mailing address

797 Main St
Presque Isle, ME 04769-2201
Phone (207) 760-9100

Other names 1

  • Presque Isle Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Presque Isle Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1417662255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "797 MAIN ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047692201",
            "telephone_number": "207-760-9100",
            "fax_number": "207-760-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 MAIN ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047692201",
            "telephone_number": "207-760-9100",
            "fax_number": "207-760-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESQUE ISLE PHARMACY CO., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "KYLIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "207-760-9100"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presque Isle Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Presque Isle Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Presque Isle, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.