Provider Demographics
NPI:1578935748
Name:YORK HOSPITAL
Entity Type:Organization
Organization Name:YORK HOSPITAL
Other - Org Name:YORK HOSPITAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUD
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-363-4321
Mailing Address - Street 1:15 HOSPITAL DR
Mailing Address - Street 2:DEPARTMENT OF PHARMACY
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1011
Mailing Address - Country:US
Mailing Address - Phone:207-363-4321
Mailing Address - Fax:207-351-2308
Practice Address - Street 1:343 US ROUTE 1
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1636
Practice Address - Country:US
Practice Address - Phone:207-363-4321
Practice Address - Fax:207-351-2308
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YORK HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-27
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPH500015373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy