Healthcare Provider Details

I. General information

NPI: 1265441323
Provider Name (Legal Business Name): EASTERN MAINE HEALTHCARE SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 PRITHAM AVE
GREENVILLE ME
04441
US

IV. Provider business mailing address

364 PRITHAM AVE
GREENVILLE ME
04441
US

V. Phone/Fax

Practice location:
  • Phone: 207-695-5220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number36400
License Number StateME

VIII. Authorized Official

Name: MARIE VIENNEAU
Title or Position: PRESIDENT
Credential:
Phone: 207-695-5271