Provider Demographics
NPI:1154923423
Name:ALBRIGHT, TAMRA ANITA
Entity type:Individual
Prefix:
First Name:TAMRA
Middle Name:ANITA
Last Name:ALBRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HANNAFORD FOOD & DRUG
Mailing Address - Street 2:15 JAY PLAZA
Mailing Address - City:JAY
Mailing Address - State:ME
Mailing Address - Zip Code:04239
Mailing Address - Country:US
Mailing Address - Phone:207-897-7033
Mailing Address - Fax:
Practice Address - Street 1:HANNAFORD FOOD & DRUG
Practice Address - Street 2:15 JAY PLAZA
Practice Address - City:JAY
Practice Address - State:ME
Practice Address - Zip Code:04239
Practice Address - Country:US
Practice Address - Phone:207-897-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist