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General NPI Number Information
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NPI Number | 1912304205
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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 | 12/02/2014
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Last Update Date | 01/04/2019
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Provider Practice Location Address
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Address Line | 41 SPRING HILL RD
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City | SACO
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State | ME
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Zip | 04072-9650
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Country | US
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Telephone | 207-294-8632
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Fax |
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Provider Business Mailing Address
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Address Line | 41 SPRING HILL RD
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City | SACO
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State | ME
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Zip | 04072-9650
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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 | SVP 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 | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 1659392819
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License Number State | ME
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