Healthcare Provider Details
I. General information
NPI: 1225200991
Provider Name (Legal Business Name): YORK COUNTY WOUND HEALING & HYPERBARIC MEDICINE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2008
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
112 SANFORD RD
WELLS ME
04090-5533
US
IV. Provider business mailing address
15 HOSPITAL DR
YORK ME
03909-1099
US
V. Phone/Fax
- Phone: 207-641-8100
- Fax: 207-641-8102
- Phone: 207-351-2398
- Fax: 207-351-2411
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PE0005X |
| Taxonomy | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name: MS.
ROBIN
LABONTE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 207-351-2391