Provider Demographics
NPI:1114350550
Name:MEDOMAK VETERINARY SERVICES
Entity Type:Organization
Organization Name:MEDOMAK VETERINARY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOWARTH
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:207-563-7786
Mailing Address - Street 1:14 ATLANTIC HWY
Mailing Address - Street 2:
Mailing Address - City:WALDOBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04572-6014
Mailing Address - Country:US
Mailing Address - Phone:207-563-7786
Mailing Address - Fax:207-563-2235
Practice Address - Street 1:14 ATLANTIC HWY
Practice Address - Street 2:
Practice Address - City:WALDOBORO
Practice Address - State:ME
Practice Address - Zip Code:04572-6014
Practice Address - Country:US
Practice Address - Phone:207-563-7786
Practice Address - Fax:207-563-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Single Specialty