Healthcare Provider Details

I. General information

NPI: 1689889370
Provider Name (Legal Business Name): TOWN OF EAST MACHIAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 1 BOX 12A
MACHIAS ME
04654-9701
US

IV. Provider business mailing address

RR 1 BOX 12A
MACHIAS ME
04654-9701
US

V. Phone/Fax

Practice location:
  • Phone: 207-255-4281
  • Fax:
Mailing address:
  • Phone: 207-255-4281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN WILLEY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 207-255-6585