Individual provider Active NPI

Mariah Sue Damon

  • Pharmacist
  • Brunswick, ME
National Provider Identifier
1770184426
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR69378 Issued in ME
Practice address
8 Gurnet Rd Ste 1
Brunswick, ME 04011-2766
Phone
(207) 373-0310
NPI assigned
Nov 7, 2020
Last updated
Jul 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PR69378 ME Primary

Addresses

Primary practice location

8 Gurnet Rd Ste 1
Brunswick, ME 04011-2766

Mailing address

24 Libby LN
West Gardiner, ME 04345-3230
Phone (207) 313-6652

Other practice location 1

95 Spring St
Auburn, ME 04210-5948
Phone (207) 783-0661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PR69378MEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hannaford Bros Co LLC PastSince Nov 1, 2020 Accepting new patients
Hannaford Bros. Co., LLC PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1604707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1770184426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 LIBBY LN",
            "city": "WEST GARDINER",
            "state": "ME",
            "postal_code": "043453230",
            "telephone_number": "207-313-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 GURNET RD STE 1",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112766",
            "telephone_number": "207-373-0310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Spring St",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "ME",
            "postal_code": "042105948",
            "country_code": "US",
            "telephone_number": "207-783-0661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMON",
        "first_name": "MARIAH",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-07",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR69378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.