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General NPI Number Information
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NPI Number | 1073674016
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Entity Type | Organization
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Legal Business Name | MAINE GENERAL COMMUNITY CARE
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 09/27/2017
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Provider Practice Location Address
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Address Line | 10 WATER ST SUITE 306
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City | WATERVILLE
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State | ME
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Zip | 04901-6559
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Country | US
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Telephone | 207-861-3488
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Fax | 207-861-3470
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Provider Business Mailing Address
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Address Line | 10 WATER ST STE 306
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City | WATERVILLE
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State | ME
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Zip | 04901-6559
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Country | US
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Telephone | 207-861-3488
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Fax | 207-861-3470
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE
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Name | ANGELA W VICTORY
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Credential |
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Telephone | 207-861-3488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 221903
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License Number State | ME
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