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NPI 1629558432

NPI 1629558432 : MAINEHEALTH : DAMARISCOTTA, ME

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General NPI Number Information
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    NPI Number           |    1629558432
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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     |    09/02/2025
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Provider Practice Location Address
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    Address Line         |    35 MILES ST 
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    City                 |    DAMARISCOTTA
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    State                |    ME
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    Zip                  |    04543-4047
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    Country              |    US
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    Telephone            |    207-563-1234
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 417 
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    City                 |    BOOTHBAY HARBOR
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    State                |    ME
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    Zip                  |    04538-0417
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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    |    ASSOCIATE 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        |    282NC0060X
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    Taxonomy Name        |    Critical Access Hospital
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    License Number       |    38124
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    License Number State |    ME
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