Amanda Bombard
Individual provider Active NPI Pharmacist · Portland, ME
NPI 1922475243 · NPPES record last updated Aug 24, 2015
Key facts
- NPI
- 1922475243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PR45413 (ME)
- Practice address
- 305 Commercial St Apt 305
Portland, ME 04101-4642 - Phone
- (207) 831-4900
- NPI assigned
- Aug 24, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR45413 | ME | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PR45413 | ME | Yes |
Addresses
Primary practice location
305 Commercial St Apt 305
Portland, ME 04101-4642
Mailing address
305 Commercial St Apt 305
Portland, ME 04101-4642
Phone (207) 831-4900
Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2015. 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.