Active NPI
Mariah Sue Damon
- Pharmacist
- Brunswick, ME
National Provider Identifier
1770184426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PR69378
- Practice address
- 8 Gurnet Rd Ste 1
Brunswick, ME 04011-2766 - Phone
- (207) 373-0310
- NPI assigned
- Nov 7, 2020
- Last updated
- Jul 29, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PR69378 | ME | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hannaford Bros Co LLC | Past | Accepting new patients | |
| Hannaford Bros. Co., LLC | Past | 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.
-
dba Hannaford Food and Drug
- Community/Retail Pharmacy
- Auburn, ME
- NPI 1831207224
-
dba Hannaford Supermarket & Pharmacy
- Community/Retail Pharmacy
- Scarborough, ME
- NPI 1861175622
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.