Provider Demographics
NPI:1366478885
Name:LEVASSEUR, PAULINE R (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:R
Last Name:LEVASSEUR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 INDIAN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-6444
Mailing Address - Country:US
Mailing Address - Phone:207-865-3628
Mailing Address - Fax:
Practice Address - Street 1:62 BARIBEAU DR
Practice Address - Street 2:MEDICAL CENTER PHARMACY AT BARIBEAU
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3218
Practice Address - Country:US
Practice Address - Phone:207-725-8100
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR3794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist