Healthcare Provider Details

I. General information

NPI: 1376879924
Provider Name (Legal Business Name): R.S.U. #9
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 11/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 LEARNING LN
FARMINGTON ME
04938-7039
US

IV. Provider business mailing address

115 LEARNING LN
FARMINGTON ME
04938-7039
US

V. Phone/Fax

Practice location:
  • Phone: 207-778-6571
  • Fax: 207-778-4160
Mailing address:
  • Phone: 207-778-6571
  • Fax: 207-778-4160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number251300000X
License Number StateME

VIII. Authorized Official

Name: DR. MICHAEL CORMIER
Title or Position: SUPERINTENDENT
Credential:
Phone: 207-778-6571