Provider Demographics
NPI:1922312461
Name:ABI YOUNES, HANI (BS PHARMACY)
Entity Type:Individual
Prefix:
First Name:HANI
Middle Name:
Last Name:ABI YOUNES
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 S MAIN ST APT 107
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-2381
Mailing Address - Country:US
Mailing Address - Phone:207-951-1014
Mailing Address - Fax:
Practice Address - Street 1:713 BROADWAY
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3225
Practice Address - Country:US
Practice Address - Phone:207-942-5521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist