Provider Demographics
NPI:1063746410
Name:MILLS, JOAN G (RPH)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:G
Last Name:MILLS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:G
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:3 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MORRILL
Mailing Address - State:ME
Mailing Address - Zip Code:04952-5101
Mailing Address - Country:US
Mailing Address - Phone:207-338-4411
Mailing Address - Fax:207-338-0519
Practice Address - Street 1:254 MAIN ST
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915
Practice Address - Country:US
Practice Address - Phone:207-338-4411
Practice Address - Fax:207-338-0519
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist