Provider Demographics
NPI:1770916462
Name:MOULIN, ARTHUR G JR (BS PHARMACY)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:G
Last Name:MOULIN
Suffix:JR
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:PO BOX 662
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-0662
Mailing Address - Country:US
Mailing Address - Phone:207-363-5616
Mailing Address - Fax:
Practice Address - Street 1:125 FIELDSTONE ESTATES RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-5823
Practice Address - Country:US
Practice Address - Phone:207-363-5616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR3075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist