Healthcare Provider Details

I. General information

NPI: 1699967224
Provider Name (Legal Business Name): RUMFORD COMMUNITY FAMILY HEALTH CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 08/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 FRANKLIN ST
RUMFORD ME
04276-2100
US

IV. Provider business mailing address

431 FRANKLIN ST
RUMFORD ME
04276-2100
US

V. Phone/Fax

Practice location:
  • Phone: 207-364-7831
  • Fax: 307-369-9467
Mailing address:
  • Phone: 207-364-7831
  • Fax: 307-369-9467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN KROGER
Title or Position: DIVISION CHIEF
Credential: MD
Phone: 207-369-0146