DR. MARYBETH BOUDREAU (NPI# 1477546380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477546380 |
| Entity Type | Individual |
| Full Name | DR. MARYBETH BOUDREAU |
| Credential | PHARM.D. |
| Practice Address |
489 State St Bangor ME 04401-6616 |
| Mailing Address |
261 Troy Center Rd Troy ME 04987-3152 |
| Practice Telephone | 2079738927 |
| Mailing Telephone | 2079482665 |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
PR4792 | ME | Pharmacy Service Providers |
| Street Address |
489 STATE ST |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-6616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790789147 | Eastern Maine Medical Center | General Acute Care Hospital | 489 State St, Bangor, ME 04401-6616 | 2005-06-13 |
| 1356956239 | Amanda Roberts | Physician Assistant | 489 State St, Bangor, ME 04401-6674 | 2020-09-09 |
| 1558983148 | Lana Caroline Hoertz | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2020-05-18 |
| 1427696954 | Kelsey A Mcgrath | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2019-12-16 |
| 1528629888 | Jaclyn Young | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2019-06-26 |
| 1568928018 | Emily Bohm | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-20 |
| 1144786971 | Andrew Hopkins | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-18 |
| 1750847083 | Daniel Patrick Conway | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-12 |
| 1306317847 | Matthew Daniel Kent | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2018-12-10 |
| 1750869061 | Brian Marsh | Nurse Practitioner | 489 State St, Bangor, ME 04401 | 2018-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811489156 | Sandra Bartlett | Pharmacist | 360 Broadway, Bangor, ME 04401-3979 | 2018-06-02 |
| 1700997970 | Ronald David Tapley | Pharmacist | 35 State Hospital Dr, Bangor, ME 04401-8816 | 2006-08-31 |
| 1174523484 | Renee Michelle Ford | Pharmacist | 489 State St, Bangor, ME 04401-6616 | 2005-07-28 |
| 1275539397 | Jamie L/ Cronin | Pharmacist | 489 State St, Bangor, ME 04401-6616 | 2005-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689122095 | Sarah Faulkingham | Pharmacist | 28 Maxwell Rd, Birch Harbor, ME 04613 | 2016-09-14 |
| 1407229032 | Elizabeth A Dragatsi | Pharmacist | 28 Cherry Hill Ter, Waterville, ME 04901-4508 | 2015-11-04 |
| 1831503309 | Theresa Marie Bonsey | Pharmacist | 73 Oakland St, Waterville, ME 04901-5240 | 2014-06-12 |
| 1063515393 | Edward William Bauer IIi | Pharmacist | One Va Center, Togus Va Medical Center, Augusta, ME 04330-6719 | 2006-09-05 |
| 1275635138 | James W Mathis | Pharmacist | 961 Augusta Rd, Bowdoin, ME 04287-7713 | 2006-09-02 |
| 1508349382 | Roger Edmond Duguay | Pharmacist | 469 Main St, Jay, ME 04239-5062 | 2018-09-07 |
| 1134612633 | Stephanie Nichols | Pharmacist | 22 Bramhall St, Portland, ME 04102-3175 | 2018-06-08 |
| 1104336213 | Matthew Jay Marston Jr. | Pharmacist | 401 N Main St, Brewer, ME 04412-1802 | 2017-10-03 |
| 1407370497 | Emily Jean Weissman | Pharmacist | 163 Van Buren Rd, Caribou, ME 04736 | 2017-08-01 |
| 1225124308 | Alyne Newell Anderson | Pharmacist | 1 Va Ctr, 119, Augusta, ME 04330-6719 | 2006-10-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.