Jeffrrey Church
Individual provider Active NPI Pharmacist · Farmingdale, ME
NPI 1992145122 · NPPES record last updated Jul 2, 2013
Key facts
- NPI
- 1992145122
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PR4081 (ME)
- Practice address
- 34 Wedgewood Dr
Farmingdale, ME 04344-2969 - Phone
- (207) 622-7310
- NPI assigned
- Jul 2, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| PR4081 | ME | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PR4081 | ME | Yes |
Addresses
Primary practice location
34 Wedgewood Dr
Farmingdale, ME 04344-2969
Mailing address
34 Wedgewood Drive
Farmingdale, ME 04344
Phone (207) 622-7310
Other providers in Farmingdale, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2013. 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.