Healthcare Provider Details

I. General information

NPI: 1912338161
Provider Name (Legal Business Name): REGIONAL MEDICAL CENTER AT LUBEC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 S LUBEC RD
LUBEC ME
04652-3620
US

IV. Provider business mailing address

43 S LUBEC RD
LUBEC ME
04652-3620
US

V. Phone/Fax

Practice location:
  • Phone: 207-733-5541
  • Fax: 207-733-4767
Mailing address:
  • Phone: 207-733-5541
  • Fax: 207-733-4767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP131107
License Number StateME

VIII. Authorized Official

Name: MARILYN HUGHES
Title or Position: CEO
Credential:
Phone: 207-733-1090