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General NPI Number Information
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NPI Number | 1508897059
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Entity Type | Organization
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Legal Business Name | MAINEHEALTH
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 216 VAUGHAN ST
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City | PORTLAND
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State | ME
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Zip | 04102
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Country | US
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Telephone | 207-842-6531
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Fax | 207-842-7773
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Provider Business Mailing Address
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Address Line | 123 ANDOVER RD
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City | WESTBROOK
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State | ME
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Zip | 04092-3848
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Country | US
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Telephone | 207-842-6531
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Fax | 207-842-7773
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | LUGENE ANTHONY INZANA
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Credential |
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Telephone | 207-661-1346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 36236
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License Number State | ME
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