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General NPI Number Information
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NPI Number | 1811288061
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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 | 04/22/2011
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 193 MAIN ST SUITE 9
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City | NORWAY
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State | ME
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Zip | 04268-5645
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Country | US
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Telephone | 207-743-8766
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Fax | 207-743-1579
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Provider Business Mailing Address
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Address Line | 181 MAIN ST
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City | NORWAY
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State | ME
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Zip | 04268-5664
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Country | US
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Telephone | 207-743-5933
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Fax | 207-743-1566
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Authorized Official
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Title or Position | ASSOCIATE CFO, MAINEHEALTH
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 37353
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 37353
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 37353
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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