Provider Demographics
NPI:1760794853
Name:MACDONALD, GARTH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:GARTH
Middle Name:
Last Name:MACDONALD
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2007
Mailing Address - Country:US
Mailing Address - Phone:207-729-8100
Mailing Address - Fax:207-729-1355
Practice Address - Street 1:156 MAINE ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2007
Practice Address - Country:US
Practice Address - Phone:207-729-8100
Practice Address - Fax:207-729-1355
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist