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General NPI Number Information
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NPI Number | 1841397932
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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 | 09/20/2006
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Last Update Date | 10/13/2024
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Provider Practice Location Address
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Address Line | 118 NORTHPORT AVE
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City | BELFAST
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State | ME
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Zip | 04915-6009
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Country | US
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Telephone | 207-338-2500
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Fax | 207-338-9368
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Provider Business Mailing Address
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Address Line | 118 NORTHPORT AVE
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City | BELFAST
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State | ME
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Zip | 04915-6009
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Country | US
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Telephone | 207-338-2500
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Fax | 207-338-9368
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Authorized Official
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Title or Position | ASSOCIATE CFO
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Name | LUGENE INZANA
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Credential |
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Telephone | 207-662-2654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 36424
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 37189
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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 | 37023
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License Number State | ME
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