Presque Isle Pharmacy Co., LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PRESQUE ISLE PHARMACY CO., LLC

Practice address

797 Main St
Presque Isle, ME 04769-2201

Phone

(207) 760-9100

Fax

(207) 760-9191

NPI assigned

Dec 16, 2006

Organization subpart

No

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

Authorized official

Name

Kailee S StilesNPI 1760939649

Title

Pharmacist

Phone

(207) 760-9100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PRESQUE ISLE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in ME2 enrollments

Enrollment records 2

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.

• Presque Isle Pharmacy Co., LLC

  • Long Term Care Pharmacy
  • Presque Isle, ME
  • NPI 1417662255
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kailee Stiles, PHARMD

  • Pharmacist
  • Presque Isle, ME
  • NPI 1760939649
  NPD Authorized official
• Dylan Royce Johnston, PHARMD

  • Pharmacist
  • Presque Isle, ME
  • NPI 1376123745
  NPD (past)

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1770645491",
    "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"
        },
        {
            "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": "2006-12-16",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "STILES",
        "authorized_official_first_name": "KAILEE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "207-760-9100"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134660000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2007436",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRESQUE ISLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacquelyn Poulin, LCPC, ATR
• Haley Ann Powers, MS, OTR/L
• Yvette Pratt, CP
• Presque Isle Healthcare Center LLC
• Presque Isle Pharmacy Co., LLC
• Tiffany Renee Jamerson Pressley, DNP, APRN, PMHNP-BC
• Frances Prest, MHRT-CSP
• Sheelagh Prosser, MD
• Amber Dawn Pulcifur, CAC7967
• Ashley A Putnam Cole, OQMHP-COMMUNITY

• Community/Retail Pharmacy in Presque Isle, ME
• Providers in Presque Isle, ME by specialty
• Community/Retail Pharmacy in Maine

• 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.
• 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.