Provider Demographics
NPI:1417388851
Name:MARANDA, TAMMY SCRIBNER (RPH, PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:SCRIBNER
Last Name:MARANDA
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:DR
Other - First Name:TAMMY
Other - Middle Name:LYNN
Other - Last Name:SCRIBNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH, PHARMD
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7027
Mailing Address - Country:US
Mailing Address - Phone:207-795-7177
Mailing Address - Fax:207-795-7552
Practice Address - Street 1:12 HIGH ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7676
Practice Address - Country:US
Practice Address - Phone:207-795-7177
Practice Address - Fax:207-795-7552
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHR2009OtherSTATE LICENSE
MAPH26984OtherSTATE LICENSE
MEPR5326OtherSTATE LICENCE