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NPI Code Detail

MEDICARE: KATAHDIN VALLEY HEALTH CENTER

MEDICARE: KATAHDIN VALLEY HEALTH 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
1261QP2300XPrimary Care Clinic/CenterRN69423ME

General Provider Information

NPI Number : 1861931404
Entity Type Code : Organization
Provider Name (Legal Business Name) : KATAHDIN VALLEY HEALTH CENTER
Provider Business Mailing Address
First Line : 529 S PATTEN RD
Second Line :
City : PATTEN
State : ME
Zip : 04765-3007
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 529 S PATTEN RD
Second Line :
City : PATTEN
State : ME
Zip : 04765-3007
Country : US
Telephone Number : 207-521-0675
Fax Number :
Authorized Official
Title or Position : NURSE MANAGER
Name : CHRISTINE MARIE REICHERT
Credential : RN
Telephone Number : 207-521-0675
Provider Enumeration Date : 02/15/2017
Last Update Date : 02/15/2017

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Directions to “KATAHDIN VALLEY HEALTH CENTER ” Practice Location

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