Provider Demographics
NPI:1295330611
Name:TORTORICH, RODNEY M JR (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:M
Last Name:TORTORICH
Suffix:JR
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 SABATTUS ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-4111
Mailing Address - Country:US
Mailing Address - Phone:207-783-3784
Mailing Address - Fax:207-782-9252
Practice Address - Street 1:446 SABATTUS ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-4111
Practice Address - Country:US
Practice Address - Phone:207-783-3784
Practice Address - Fax:207-783-2892
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR3910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist