Provider Demographics
NPI:1659918738
Name:CLOUTIER, DREW RONALD DOMINIQUE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:RONALD DOMINIQUE
Last Name:CLOUTIER
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 1:770 ROOSEVELT TRL
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-5300
Mailing Address - Country:US
Mailing Address - Phone:207-892-2541
Mailing Address - Fax:
Practice Address - Street 1:335 ALFRED ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-3128
Practice Address - Country:US
Practice Address - Phone:207-282-1577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-07
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY-00908183500000X
MEPR69311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist