Healthcare Provider Details

I. General information

NPI: 1063438042
Provider Name (Legal Business Name): BIO-MEDICAL APPLICATIONS OF MAINE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 CIVIC CENTER DR
AUGUSTA ME
04330-8028
US

IV. Provider business mailing address

164 CIVIC CENTER DR
AUGUSTA ME
04330-8028
US

V. Phone/Fax

Practice location:
  • Phone: 207-622-7097
  • Fax: 207-622-9217
Mailing address:
  • Phone: 207-622-7097
  • Fax: 207-622-9217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BARRY L BLANTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 781-699-9000