Provider Demographics
NPI:1497518658
Name:JOBST, EDWARD ARTHUR (RPH)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:ARTHUR
Last Name:JOBST
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 OHIO ST APT 9
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-2800
Mailing Address - Country:US
Mailing Address - Phone:207-299-5608
Mailing Address - Fax:
Practice Address - Street 1:24 WALTON DR
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1001
Practice Address - Country:US
Practice Address - Phone:207-989-6174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR71820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist