Healthcare Provider Details

I. General information

NPI: 1659388213
Provider Name (Legal Business Name): CHARLES A DEAN MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 PRITHAM AVE
GREENVILLE ME
04441-1129
US

IV. Provider business mailing address

PO BOX 1129 364 PRITHAM AVENUE
GREENVILLE ME
04441-1129
US

V. Phone/Fax

Practice location:
  • Phone: 207-695-5215
  • Fax: 207-695-2329
Mailing address:
  • Phone: 207-695-5200
  • Fax: 207-695-2329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number37002
License Number StateME

VIII. Authorized Official

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