MEDICARE: CALAIS COMMUNITY HOSPITAL

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
1	275N00000X	Medicare Defined Swing Bed Hospital Unit	36210	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0012304	OTHER	ME	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0439887	OTHER	ME	CIGNA
4	010211783	OTHER	ME	TRICARE
5	000008	OTHER	ME	ANTHEM BLUE CROSS
6	900800	OTHER	ME	HARVARD PILGRIM

General Provider Information

NPI Number	:	1376546143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALAIS COMMUNITY HOSPITAL

Provider Business Mailing Address
First Line	:	24 HOSPITAL LN
Second Line	:
City	:	CALAIS
State	:	ME
Zip	:	04619-1329
Country	:	US
Telephone Number	:	207-454-7521
Fax Number	:	207-454-3616

Provider Business Practice Location Address
First Line	:	24 HOSPITAL LN
Second Line	:
City	:	CALAIS
State	:	ME
Zip	:	04619-1329
Country	:	US
Telephone Number	:	207-454-7521
Fax Number	:	207-454-3616

Authorized Official
Title or Position	:	CFO
Name	:	LYNNETTE PARR
Credential	:
Telephone Number	:	207-255-0269

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/30/2021

Similar Medicare Providers

1922001049 — CALAIS COMMUNITY HOSPITAL
Practice Location Address:

24 HOSPITAL LN
CALAIS, ME
04619-1329

Practice Phone: 207-454-7521
Practice Fax: 207-454-3616

1073500633 — WILLIAM J. WALDRON CRNA
Practice Location Address:

24 HOSPITAL LN
CALAIS, ME
04619-1329

Practice Phone: 207-454-7521
Practice Fax: 207-454-9247

1215918461 — DR. ELIZABETH ELIACIN MD
Practice Location Address:

24 HOSPITAL LN
CALAIS, ME
04619-1329

Practice Phone: 207-454-9300
Practice Fax: 207-454-9238

1811962988 — WENDY J CRAWFORD M.D.
Practice Location Address:

24 HOSPITAL LN
CALAIS, ME
04619-1329

Practice Phone: 207-454-8432
Practice Fax: 207-454-8333

1255390753 — DAVID C BRILLIOTT CRNA
Practice Location Address:

22 HOSPITAL LN
CALAIS, ME
04619-1329

Practice Phone: 207-454-7521
Practice Fax: 207-454-3616

1801856174 — ROBERT CHARLES ROGERS CRNA
Practice Location Address:

22 HOSPITAL LN
CALAIS, ME
04619-1329

Practice Phone: 207-454-7521
Practice Fax: 207-454-3616

Directions to “CALAIS COMMUNITY HOSPITAL ” Practice Location

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