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General NPI Number Information
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NPI Number | 1417052994
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Entity Type | Organization
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Legal Business Name | MMS SOUTHERN MAINE, INC.
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 55 SPRING ST SUITE B
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City | SCARBOROUGH
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State | ME
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Zip | 04074-8926
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Country | US
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Telephone | 207-510-0045
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Fax | 207-510-0049
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Provider Business Mailing Address
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Address Line | 49 TOPSHAM FAIR MALL RD SUITE 7
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City | TOPSHAM
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State | ME
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Zip | 04086-1734
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Country | US
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Telephone | 207-729-6990
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Fax | 207-729-8418
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TYRRELL HUNTER
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Credential |
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Telephone | 207-510-0045
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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 |
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License Number State |
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