Provider Demographics
NPI:1912373747
Name:WOOD, LORI BETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:BETH
Last Name:WOOD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:BETH
Other - Last Name:SCHILDROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:268 WATER ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:ME
Mailing Address - Zip Code:04346-5217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:268 WATER ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:ME
Practice Address - Zip Code:04346-5217
Practice Address - Country:US
Practice Address - Phone:207-588-2482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449113183500000X
MEPR27908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist