Healthcare Provider Details

I. General information

NPI: 1306018072
Provider Name (Legal Business Name): SEACOAST SURGERY
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

16 HOSPITAL DR
YORK ME
03909-1099
US

IV. Provider business mailing address

74 INDUSTRIAL PARK RD LABORATORY BILLING SERVICES
SACO ME
04072
US

V. Phone/Fax

Practice location:
  • Phone: 207-351-3577
  • Fax: 207-351-3578
Mailing address:
  • Phone: 800-286-4684
  • Fax: 207-286-3218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. ROBIN LABONTE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 207-351-2391