Provider Demographics
NPI:1235606377
Name:NATHAN'S WELLNESS PHARMACY AND APOTHECARY
Entity Type:Organization
Organization Name:NATHAN'S WELLNESS PHARMACY AND APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:207-390-0485
Mailing Address - Street 1:42 GLEASON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04861-3458
Mailing Address - Country:US
Mailing Address - Phone:207-390-0485
Mailing Address - Fax:855-696-8399
Practice Address - Street 1:185 TOWNSEND AVE
Practice Address - Street 2:
Practice Address - City:BOOTHBAY HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04538-1894
Practice Address - Country:US
Practice Address - Phone:207-390-0485
Practice Address - Fax:855-696-8399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy