Healthcare Provider Details

I. General information

NPI: 1548382328
Provider Name (Legal Business Name): MRH CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 W MAIN ST SUITE 200
DOVER FOXCROFT ME
04426-1059
US

IV. Provider business mailing address

897 W MAIN ST
DOVER FOXCROFT ME
04426-1029
US

V. Phone/Fax

Practice location:
  • Phone: 207-564-4464
  • Fax: 207-564-4461
Mailing address:
  • Phone: 207-564-4464
  • Fax: 207-564-4461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIE VIENNEAU
Title or Position: PRESIDENT
Credential:
Phone: 207-564-4251