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NPI Code Detail

MEDICARE: RUTH E COOK CCC/A

MEDICARE: RUTH E COOK CCC/A
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
1231H00000XAudiologistAP1052ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2027843OTHERMEANTHEM

General Provider Information

NPI Number : 1689663080
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUTH E COOK CCC/A
Provider Business Mailing Address
First Line : 301C US ROUTE 1
Second Line :
City : SCARBOROUGH
State : ME
Zip : 04074-9701
Country : US
Telephone Number : 207-396-8600
Fax Number : 207-396-8632
Provider Business Practice Location Address
First Line : 1250 FOREST AVE
Second Line : SUITE 301
City : PORTLAND
State : ME
Zip : 04103-1884
Country : US
Telephone Number : 207-797-5753
Fax Number : 207-878-1715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 04/03/2012

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Directions to “ RUTH E COOK CCC/A” Practice Location

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