Healthcare Provider Details

I. General information

NPI: 1811288061
Provider Name (Legal Business Name): MAINEHEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 MAIN ST SUITE 9
NORWAY ME
04268-5645
US

IV. Provider business mailing address

181 MAIN ST
NORWAY ME
04268-5664
US

V. Phone/Fax

Practice location:
  • Phone: 207-743-8766
  • Fax: 207-743-1579
Mailing address:
  • Phone: 207-743-5933
  • Fax: 207-743-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number37353
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number37353
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number37353
License Number StateME
# 4
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUGENE ANTHONY INZANA
Title or Position: ASSOCIATE CFO, MAINEHEALTH
Credential:
Phone: 207-661-1346