Provider Demographics
NPI:1821034760
Name:APOTHECARY RX INC.
Entity Type:Organization
Organization Name:APOTHECARY RX INC.
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:H
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:207-783-3539
Mailing Address - Street 1:373 SABATTUS ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5429
Mailing Address - Country:US
Mailing Address - Phone:207-783-3539
Mailing Address - Fax:207-786-9252
Practice Address - Street 1:373 SABATTUS ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5429
Practice Address - Country:US
Practice Address - Phone:207-783-3539
Practice Address - Fax:207-786-9252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPH50001254332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME2003604OtherNCPDP #
ME432259400Medicaid
MEBA9778688OtherDEA #
MEBA9778688OtherDEA #