Healthcare Provider Details

I. General information

NPI: 1053440321
Provider Name (Legal Business Name): SURGICARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 HAMMOND ST STE 1
BANGOR ME
04401-4388
US

IV. Provider business mailing address

3 FEDERAL ST STE 110
BILLERICA MA
01821-3500
US

V. Phone/Fax

Practice location:
  • Phone: 207-947-8454
  • Fax: 207-872-7471
Mailing address:
  • Phone: 800-797-8744
  • Fax: 800-338-6304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number332B00000X
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number335E00000X
License Number StateME

VIII. Authorized Official

Name: MR. ANDRES MORENO III
Title or Position: PRESIDENT
Credential:
Phone: 866-356-7846