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NPI Code Detail

MEDICARE: NORTH COUNTRY ASSOCIATES, INC

MEDICARE: NORTH COUNTRY ASSOCIATES, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility36371ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1038428OTHERMEBLUE CROSS PROVIDER #

General Provider Information

NPI Number : 1154481398
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH COUNTRY ASSOCIATES, INC
Provider Business Mailing Address
First Line : 179 LISBON ST
Second Line : 2ND FLOOR
City : LEWISTON
State : ME
Zip : 04240-7248
Country : US
Telephone Number : 207-786-3554
Fax Number : 207-786-8507
Provider Business Practice Location Address
First Line : 174 MAIN ST
Second Line :
City : MADISON
State : ME
Zip : 04950-1523
Country : US
Telephone Number : 207-696-8225
Fax Number : 207-696-5612
Authorized Official
Title or Position : VP OF FINANCE
Name : MR. GLEN G CYR
Credential :
Telephone Number : 207-786-3554
Provider Enumeration Date : 12/11/2006
Last Update Date : 08/22/2020

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Directions to “NORTH COUNTRY ASSOCIATES, INC ” Practice Location

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