MEDICARE: UNIVERSITY OF MAINE AT FARMINGTON

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	251300000X	Local Education Agency (LEA)	9841	ME

General Provider Information

NPI Number	:	1306944251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF MAINE AT FARMINGTON

Provider Business Mailing Address
First Line	:	111 SOUTH ST
Second Line	:	STUDENT HEALTH CENTER
City	:	FARMINGTON
State	:	ME
Zip	:	04938-6823
Country	:	US
Telephone Number	:	207-778-7200
Fax Number	:	207-778-8183

Provider Business Practice Location Address
First Line	:	251 MAIN ST
Second Line	:	SCOTT HALL
City	:	FARMINGTON
State	:	ME
Zip	:	04938-1744
Country	:	US
Telephone Number	:	207-778-7200
Fax Number	:	207-778-8183

Authorized Official
Title or Position	:	CO-DIRECTOR
Name	:	SUSAN E COCHRAN
Credential	:	M.D.
Telephone Number	:	207-778-7200

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	08/22/2020

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