MEDICARE: PARKVIEW ADVENTIST 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	36117	ME

General Provider Information

NPI Number	:	1760485304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKVIEW ADVENTIST MEDICAL CENTER

Provider Business Mailing Address
First Line	:	329 MAINE ST
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-3310
Country	:	US
Telephone Number	:	207-373-2000
Fax Number	:	207-721-0258

Provider Business Practice Location Address
First Line	:	329 MAINE ST
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-3310
Country	:	US
Telephone Number	:	207-373-2000
Fax Number	:	207-721-0258

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MR. WILLIAM GANNON
Credential	:
Telephone Number	:	207-373-2295

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	04/20/2008

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