Provider Demographics
NPI:1013096627
Name:GILLETTE, TRUMAN L (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:TRUMAN
Middle Name:L
Last Name:GILLETTE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 STEAMBOAT ST
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1310
Mailing Address - Country:US
Mailing Address - Phone:207-454-8147
Mailing Address - Fax:
Practice Address - Street 1:401 PETER DANA POINT
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:ME
Practice Address - Zip Code:04668
Practice Address - Country:US
Practice Address - Phone:207-796-2321
Practice Address - Fax:207-796-5328
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist