MEDICARE: MRH CORP.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC3866	OTHER	ME	RAILROAD MEDICARE
2	C22673	OTHER	ME	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1033231154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MRH CORP.

Provider Business Mailing Address
First Line	:	897 W MAIN ST
Second Line	:
City	:	DOVER FOXCROFT
State	:	ME
Zip	:	04426-1029
Country	:	US
Telephone Number	:	207-943-7752
Fax Number	:	207-943-1002

Provider Business Practice Location Address
First Line	:	135 PARK STREET
Second Line	:
City	:	MILO
State	:	ME
Zip	:	04463
Country	:	US
Telephone Number	:	207-943-7752
Fax Number	:	207-943-1002

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIE VIENNEAU
Credential	:
Telephone Number	:	207-564-4251

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	04/23/2020

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Directions to “MRH CORP. ” Practice Location

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