Healthcare Provider Details

I. General information

NPI: 1417446121
Provider Name (Legal Business Name): MAINE URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 TOPSHAM FAIR MALL RD STE 8
TOPSHAM ME
04086-1773
US

IV. Provider business mailing address

364 MAIN ST
LEWISTON ME
04240-7029
US

V. Phone/Fax

Practice location:
  • Phone: 207-798-6333
  • Fax: 207-798-6335
Mailing address:
  • Phone: 207-795-5646
  • Fax: 207-795-7193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID THOMPSON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 207-795-2813