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Contact Information

BRADLEY BOUCHARD
302 MAIN ST
OLD TOWN, ME04468-1535
 Phone: 207-827-8021
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacist

183500000X
Indicates primary specialty

NPI Profile & details for BRADLEY BOUCHARD · (Male)

NPI Number 1629486774
Status Active
Credentials
Entity Individual
Enumeration date 07/31/2014
Last updated 07/31/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • ME License # PR27869
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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