Provider Demographics
NPI:1851656748
Name:BRASSBRIDGE, MAY E
Entity Type:Individual
Prefix:MS
First Name:MAY
Middle Name:E
Last Name:BRASSBRIDGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-2816
Mailing Address - Country:US
Mailing Address - Phone:207-596-0036
Mailing Address - Fax:207-596-7943
Practice Address - Street 1:254 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6572
Practice Address - Country:US
Practice Address - Phone:207-338-4411
Practice Address - Fax:207-338-0519
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-07
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPI12083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist