Provider Demographics
NPI:1659152437
Name:LEWIS, KIMBERLEE JULENE (RPH)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLEE
Middle Name:JULENE
Last Name:LEWIS
Suffix:
Gender:F
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:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04332-0528
Mailing Address - Country:US
Mailing Address - Phone:800-730-4840
Mailing Address - Fax:
Practice Address - Street 1:16 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-7888
Practice Address - Country:US
Practice Address - Phone:800-730-4840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR71625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist