Provider Demographics
NPI:1225321961
Name:ORONO MED NOW
Entity Type:Organization
Organization Name:ORONO MED NOW
Other - Org Name:ORONO PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:REZA
Authorized Official - Last Name:AGHAMOOSA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:207-866-3800
Mailing Address - Street 1:16 MILL STREET
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 MILL STREET
Practice Address - Street 2:UITE 4
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473
Practice Address - Country:US
Practice Address - Phone:207-866-3800
Practice Address - Fax:207-866-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center