Provider Demographics
NPI:1336312164
Name:MILLS, NEIL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:MILLS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 BROADWAY
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-907-1612
Mailing Address - Fax:207-907-1906
Practice Address - Street 1:360 BROADWAY
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-907-1612
Practice Address - Fax:207-907-1906
Is Sole Proprietor?:No
Enumeration Date:2008-04-13
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5497183500000X
CTPCT.0010796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist