Healthcare Provider Details

I. General information

NPI: 1245292788
Provider Name (Legal Business Name): ST. MARY'S REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 CAMPUS AVENUE
LEWISTON ME
04240-6030
US

IV. Provider business mailing address

PO BOX 95000 LBX 7650
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 207-777-8100
  • Fax: 207-777-8800
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number38244
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH W WOOD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 207-777-8865