Healthcare Provider Details

I. General information

NPI: 1134200702
Provider Name (Legal Business Name): CALAIS COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 PALMER ST
CALAIS ME
04619-1305
US

IV. Provider business mailing address

43 PALMER ST
CALAIS ME
04619-1305
US

V. Phone/Fax

Practice location:
  • Phone: 207-454-8150
  • Fax: 207-454-0256
Mailing address:
  • Phone: 207-454-8150
  • Fax: 207-454-0256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number208509
License Number StateME

VIII. Authorized Official

Name: LYNNETTE PARR
Title or Position: CFO
Credential:
Phone: 207-255-0269