Healthcare Provider Details

I. General information

NPI: 1932152279
Provider Name (Legal Business Name): EASTERN MAINE HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 LAWRENCE DRIVE
FAIRFIELD ME
04937
US

IV. Provider business mailing address

24 LAWRENCE DR
FAIRFIELD ME
04937
US

V. Phone/Fax

Practice location:
  • Phone: 207-453-2499
  • Fax:
Mailing address:
  • Phone: 207-453-2499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number02737
License Number StateME

VIII. Authorized Official

Name: SYLVIA A SOUCY
Title or Position: BILLING MANAGER
Credential:
Phone: 207-498-2578