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General NPI Number Information
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NPI Number | 1174671150
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Entity Type | Organization
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Legal Business Name | ACADIA MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 274 MAIN ST
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City | FORT FAIRFIELD
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State | ME
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Zip | 04742-1121
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Country | US
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Telephone | 207-472-1234
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Fax | 207-472-1235
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Provider Business Mailing Address
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Address Line | 1019 TOWN DR
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City | HIGHLAND HEIGHTS
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State | KY
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Zip | 41076-9114
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GREGORY J CRAWFORD
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Credential |
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Telephone | 859-300-6455
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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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