MEDICARE: MAINEHEALTH

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	282N00000X	General Acute Care Hospital	37025	ME
2	282N00000X	General Acute Care Hospital	37563	ME

General Provider Information

NPI Number	:	1053647024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAINEHEALTH

Provider Business Mailing Address
First Line	:	22 BRAMHALL ST
Second Line	:	FINANCE DEPARTMENT MGB 1ST FLOOR
City	:	PORTLAND
State	:	ME
Zip	:	04102-3134
Country	:	US
Telephone Number	:	207-662-3998
Fax Number	:	207-662-6234

Provider Business Practice Location Address
First Line	:	100 CAMPUS DR
Second Line	:	UNIT 103
City	:	SCARBOROUGH
State	:	ME
Zip	:	04074-7171
Country	:	US
Telephone Number	:	207-885-7683
Fax Number	:

Authorized Official
Title or Position	:	ASSOCIATE CFO
Name	:	LUGENE ANTHONY INZANA
Credential	:
Telephone Number	:	207-662-3538

Provider Enumeration Date	:	10/27/2009
Last Update Date	:	05/11/2020

Similar Medicare Providers

1689678112 — DR. GARY M HOCHHEISER MD
Practice Location Address:

100 CAMPUS DR , SUITE 121
SCARBOROUGH, ME
04074-7171

Practice Phone: 207-396-7700
Practice Fax:

1265402176 — HANS G BOWDER ANP-C
Practice Location Address:

100 CAMPUS DR , SUITE 125
SCARBOROUGH, ME
04074-7171

Practice Phone: 207-883-0069
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1528006772 — CHELSY GILROY
Practice Location Address:

100 CAMPUS DR , UNIT 107
SCARBOROUGH, ME
04074-7171

Practice Phone: 207-885-7565
Practice Fax:

1124063441 — LESLIE SIRIYA BRADFORD MD
Practice Location Address:

100 CAMPUS DR STE 125
SCARBOROUGH, ME
04074-7171

Practice Phone: 207-883-0069
Practice Fax:

1417977067 — SCOT C REMICK MD
Practice Location Address:

100 CAMPUS DR , SUITE 121
SCARBOROUGH, ME
04074-7171

Practice Phone: 207-396-7760
Practice Fax: 207-396-8500

1023030293 — MARY COLE-ALMGREN PA-C
Practice Location Address:

100 CAMPUS DR , SUITE 108
SCARBOROUGH, ME
04074-7171

Practice Phone: 207-396-7600
Practice Fax: 207-396-7610

1962668863 — JESSICA H CARY MS, RN, CGC
Practice Location Address:

100 CAMPUS DR , UNIT 108
SCARBOROUGH, ME
04074-7171

Practice Phone: 207-396-8772
Practice Fax:

Directions to “MAINEHEALTH ” Practice Location

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