MEDICARE: CALAIS COMMUNITY HOSPITAL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	207X00000X	Orthopaedic Surgery Physician
3	363L00000X	Nurse Practitioner
4	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1205259736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALAIS COMMUNITY HOSPITAL

Provider Business Mailing Address
First Line	:	24 HOSPITAL LN
Second Line	:
City	:	CALAIS
State	:	ME
Zip	:	04619-1329
Country	:	US
Telephone Number	:	207-454-8432
Fax Number	:	207-454-8333

Provider Business Practice Location Address
First Line	:	37 PALMER ST
Second Line	:
City	:	CALAIS
State	:	ME
Zip	:	04619-1341
Country	:	US
Telephone Number	:	207-454-7361
Fax Number	:

Authorized Official
Title or Position	:	PFS DIRECTOR
Name	:	TAMMY MITCHELL
Credential	:
Telephone Number	:	207-454-9211

Provider Enumeration Date	:	02/04/2014
Last Update Date	:	11/10/2021

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Directions to “CALAIS COMMUNITY HOSPITAL ” Practice Location

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