Provider Demographics
NPI:1376945527
Name:ROARKE, KERRY E (PHARMD, RPH, C-SPI)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:E
Last Name:ROARKE
Suffix:
Gender:F
Credentials:PHARMD, RPH, C-SPI
Other - Prefix:DR
Other - First Name:KERRY
Other - Middle Name:E
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH, C-SPI
Mailing Address - Street 1:901 WASHINGTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2862
Mailing Address - Country:US
Mailing Address - Phone:207-662-9082
Mailing Address - Fax:
Practice Address - Street 1:901 WASHINGTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2862
Practice Address - Country:US
Practice Address - Phone:207-662-9082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH232528183500000X
NY057072183500000X
MEPR45947183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist