NPIMap

Organization Active NPI

M Drug LLC

  • Community/Retail Pharmacy
  • Brewer, ME
National Provider Identifier
1780913111
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH50001489 Issued in ME
Legal business name
M DRUG LLC
Practice address
33 Whiting Hill Rd Ste 4
Brewer, ME 04412-1022
Phone
(207) 973-9444
Fax
(207) 973-9441
NPI assigned
Dec 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Authorized official

Name
Matthew J Marston, PHARMD
Title
Director of Pharmacy
Phone
(207) 275-3239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH50001489 ME Primary

Addresses

Primary practice location

33 Whiting Hill Rd Ste 4
Brewer, ME 04412-1022

Mailing address

PO Box 1779
Bangor, ME 04402-1779
Phone (207) 275-3211

Other identifiers 2

IdentifierTypeStateIssuer
2125078OtherPK
1780913111MedicaidME

Other names 1

  • NORTHERN LIGHT PHARMACY WHITING HILL Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930034165 ME DME Supplier - Pharmacy 6305037367 Practice locations: Brewer, ME
O20130129000000 ME Part B Supplier - Mass Immunization (Roster Biller Only) 6305037367 8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bangor, ME; Brewer, ME; Ellsworth, ME; Portland, ME

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Miller Drug Whiting Hill33 Whiting Hill Rd, Brewer, ME 04412-1022(207) 973-9444 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Dec 17, 2012

National Provider Directory

National Provider Directory
Tax ID family
M Drug LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1780913111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1779",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021779",
            "telephone_number": "207-275-3211",
            "fax_number": "207-561-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WHITING HILL RD STE 4",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121022",
            "telephone_number": "207-973-9444",
            "fax_number": "207-973-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M DRUG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-14",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "MARSTON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "207-275-3239",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ME",
            "license": "PH50001489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125078",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780913111",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHERN LIGHT PHARMACY WHITING HILL",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Brewer, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.