Provider Demographics
NPI:1780685628
Name:PIN RX, LLC
Entity type:Organization
Organization Name:PIN RX, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAVAREE
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:207-817-7324
Mailing Address - Street 1:31 WABANAKI WAY
Mailing Address - Street 2:
Mailing Address - City:INDIAN ISLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04468-1252
Mailing Address - Country:US
Mailing Address - Phone:866-746-7985
Mailing Address - Fax:877-746-7985
Practice Address - Street 1:31 WABANAKI WAY
Practice Address - Street 2:
Practice Address - City:INDIAN ISLAND
Practice Address - State:ME
Practice Address - Zip Code:04468-1252
Practice Address - Country:US
Practice Address - Phone:866-746-7985
Practice Address - Fax:877-746-7985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty