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General NPI Number Information
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NPI Number | 1558841353
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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 | 08/21/2018
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Last Update Date | 05/11/2020
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Provider Practice Location Address
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Address Line | 35 JULY ST
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City | SANFORD
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State | ME
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Zip | 04073-1909
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Country | US
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Telephone | 207-490-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER DR
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City | BIDDEFORD
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State | ME
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Zip | 04005-9422
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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 | SENIOR VICE PRESIDENT FINANCE & CFO
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Name | LUGENE ANTHONY INZANA
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Credential |
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Telephone | 207-662-3538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2031
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2787
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License Number State | ME
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