Healthcare Provider Details

I. General information

NPI: 1013176544
Provider Name (Legal Business Name): SEBASTICOOK VALLEY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 N MAIN ST
PITTSFIELD ME
04967-3707
US

IV. Provider business mailing address

447 N MAIN ST
PITTSFIELD ME
04967-3707
US

V. Phone/Fax

Practice location:
  • Phone: 207-848-5846
  • Fax: 207-487-4585
Mailing address:
  • Phone: 207-487-5141
  • Fax: 207-487-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number36461
License Number StateME

VIII. Authorized Official

Name: RANDALL CLARK
Title or Position: VP OF FINANCE
Credential:
Phone: 207-487-5141