Provider Demographics
NPI:1851819098
Name:BOOBAR, DANYLE MARIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:DANYLE
Middle Name:MARIE
Last Name:BOOBAR
Suffix:
Gender:F
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 1:97 OAK ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6516
Mailing Address - Country:US
Mailing Address - Phone:207-945-0351
Mailing Address - Fax:207-945-0408
Practice Address - Street 1:97 OAK ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6516
Practice Address - Country:US
Practice Address - Phone:207-945-0351
Practice Address - Fax:207-945-0408
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR46869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist