Healthcare Provider Details

I. General information

NPI: 1548463623
Provider Name (Legal Business Name): MRH CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

897 W MAIN STREET
DOVER FOXCROFT ME
04426
US

IV. Provider business mailing address

897 W MAIN ST
DOVER FOXCROFT ME
04426
US

V. Phone/Fax

Practice location:
  • Phone: 207-564-8401
  • Fax:
Mailing address:
  • Phone: 207-564-8401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number36667
License Number StateME

VIII. Authorized Official

Name: RANDALL CLARK
Title or Position: PRESIDENT
Credential:
Phone: 207-564-4256