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BONAVY GUSACK PHARM.D.
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1891855599
Individual Registrant: BONAVY GUSACK PHARM.D.
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1 VA MEDICAL CENTER VA MEDICAL CENTER TOGUS, ME 04330 US
Tel: 207-623-8411 Fax: --
Tel: 207-623-8411 Fax: --
Contact information for business:
PO BOX 3041 AUGUSTA, ME 04330-3041 US
Tel: 315-280-6726 Fax: --
Tel: 315-280-6726 Fax: --
Registration Information:
NPI: 1891855599
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | ME | PR5279 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
