Healthcare Provider Details

I. General information

NPI: 1134033772
Provider Name (Legal Business Name): MID-COAST HEALTH NET INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 WHITE ST
ROCKLAND ME
04841-2978
US

IV. Provider business mailing address

22 WHITE ST
ROCKLAND ME
04841-2978
US

V. Phone/Fax

Practice location:
  • Phone: 207-680-4545
  • Fax: 207-680-4544
Mailing address:
  • Phone: 207-680-4545
  • Fax: 207-680-4544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL

VIII. Authorized Official

Name: NICOLLE BAADE
Title or Position: OPERATIONS DIRECTOR
Credential: MHA
Phone: 207-680-4545