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General NPI Number Information
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NPI Number | 1124153499
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Entity Type | Organization
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Legal Business Name | SURGICARE INC
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 190 RIVERSIDE ST SUITE 6A
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City | PORTLAND
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State | ME
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Zip | 04103-1073
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Country | US
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Telephone | 207-773-7896
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Fax | 207-773-4645
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Provider Business Mailing Address
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Address Line | 71 1ST AVE
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City | WALTHAM
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State | MA
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Zip | 02451-1105
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Country | US
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Telephone | 800-797-8744
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Fax | 800-338-6304
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | DARCY ANN DILIDDO
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Credential |
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Telephone | 781-290-1807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 332B00000X
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 335E00000X
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License Number State | ME
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