Healthcare Provider Details

I. General information

NPI: 1912514746
Provider Name (Legal Business Name): ANDROSCOGGIN HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2020
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 STRAWBERRY AVE
LEWISTON ME
04240-5941
US

IV. Provider business mailing address

15 STRAWBERRY AVE
LEWISTON ME
04240-5941
US

V. Phone/Fax

Practice location:
  • Phone: 207-777-7740
  • Fax: 207-777-7748
Mailing address:
  • Phone: 207-777-7740
  • Fax: 207-777-7748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH JOSEPH ALBERT
Title or Position: CEO/PRESIDENT
Credential: RN
Phone: 207-795-9442