Provider Demographics
NPI:1265271779
Name:NATHAN'S WELLNESS PHARMACY AND APOTHECARY
Entity type:Organization
Organization Name:NATHAN'S WELLNESS PHARMACY AND APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:207-315-2280
Mailing Address - Street 1:185 TOWNSEND AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BOOTHBAY HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04538-1895
Mailing Address - Country:US
Mailing Address - Phone:207-315-2280
Mailing Address - Fax:207-315-2279
Practice Address - Street 1:185 TOWNSEND AVE STE C
Practice Address - Street 2:
Practice Address - City:BOOTHBAY HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04538-1895
Practice Address - Country:US
Practice Address - Phone:207-315-2280
Practice Address - Fax:207-315-2279
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATHAN'S WELLNESS PHARMACY & APOTHECARY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy