Provider Demographics
NPI:1962291468
Name:FISH RIVER RURAL HEALTH
Entity type:Organization
Organization Name:FISH RIVER RURAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:207-316-9699
Mailing Address - Street 1:10 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE LAKE
Mailing Address - State:ME
Mailing Address - Zip Code:04739-3060
Mailing Address - Country:US
Mailing Address - Phone:207-444-5973
Mailing Address - Fax:
Practice Address - Street 1:12 BOLDUC AVE
Practice Address - Street 2:
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-1602
Practice Address - Country:US
Practice Address - Phone:207-316-9699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FISH RIVER RURAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy