Healthcare Provider Details

I. General information

NPI: 1992621056
Provider Name (Legal Business Name): SEACOAST VITAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

8 TARTON RD
YORK ME
03909-5319
US

IV. Provider business mailing address

647 US ROUTE 1 STE 14
YORK ME
03909-1651
US

V. Phone/Fax

Practice location:
  • Phone: 207-292-9484
  • Fax:
Mailing address:
  • Phone: 207-292-9484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. DEVORA L GAVEL
Title or Position: OWNER
Credential:
Phone: 207-292-9484