MEDICARE: NORTHERN MAINE MEDICAL CENTER

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	36151	ME
2	282N00000X	General Acute Care Hospital	36943	ME
3	282N00000X	General Acute Care Hospital	37310	ME
4	282NC0060X	Critical Access Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000065	OTHER	ME	ANTHEM BCBS PROVIDER #

General Provider Information

NPI Number	:	1568465144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN MAINE MEDICAL CENTER

Provider Business Mailing Address
First Line	:	194 EAST MAIN STREET
Second Line	:
City	:	FORT KENT
State	:	ME
Zip	:	04743-1428
Country	:	US
Telephone Number	:	207-834-3155
Fax Number	:	207-834-2949

Provider Business Practice Location Address
First Line	:	194 EAST MAIN STREET
Second Line	:
City	:	FORT KENT
State	:	ME
Zip	:	04743-1428
Country	:	US
Telephone Number	:	207-834-3155
Fax Number	:	207-834-2949

Authorized Official
Title or Position	:	CEO
Name	:	MR. JEFFREY ZEWE
Credential	:
Telephone Number	:	207-834-1411

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	12/04/2024

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Directions to “NORTHERN MAINE MEDICAL CENTER ” Practice Location

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