MEDICARE: MARCIA L VANBUSKIRK

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	376J00000X	Homemaker	1114576980	ME
2	3747P1801X	Personal Care Attendant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1114576980	OTHER	ME	VETERANS ADMINISTRATION
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922665348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA L VANBUSKIRK

Provider Business Mailing Address
First Line	:	353 CUSHING RD
Second Line	:
City	:	CUSHING
State	:	ME
Zip	:	04563-3118
Country	:	US
Telephone Number	:	207-354-5429
Fax Number	:	207-354-5429

Provider Business Practice Location Address
First Line	:	353 CUSHING RD
Second Line	:
City	:	CUSHING
State	:	ME
Zip	:	04563-3118
Country	:	US
Telephone Number	:	207-354-5429
Fax Number	:	207-354-5429

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2019
Last Update Date	:	03/01/2021

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Directions to “ MARCIA L VANBUSKIRK ” Practice Location

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