Gerald L. Brace, RPH.
Individual provider Active NPI Pharmacist · Togus, ME
NPI 1720173388 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720173388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2920 (ME)
- Practice address
- 1 VA Center
Vamroc
Togus, ME 04330 - Phone
- (207) 623-8411
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2920 | ME | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2920 | ME | Yes |
Addresses
Primary practice location
1 VA Center
Vamroc
Togus, ME 04330
Mailing address
12 Bailey Lane
Brunswick, ME 04011
Phone (207) 623-8411
Other providers in Togus, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.