Healthcare Provider Details

I. General information

NPI: 1407242522
Provider Name (Legal Business Name): ST. MARY'S REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

791 TURNER ST UNIT 2
AUBURN ME
04210-6314
US

IV. Provider business mailing address

PO BOX 95000 LBX 7650
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 207-330-3900
  • Fax: 207-330-3940
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number38244
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DONALD H BEVERS JR.
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 207-777-8865