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NPI Code Detail

MEDICARE: INTERMED, PA

MEDICARE: INTERMED, PA
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
1261QA1903XAmbulatory Surgical Clinic/Center38444ME

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P02306616OTHERMERAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942388418
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERMED, PA
Provider Business Mailing Address
First Line : 100 GANNETT DRIVE
Second Line : SUITE C
City : SOUTH PORTLAND
State : ME
Zip : 04106
Country : US
Telephone Number : 207-347-2947
Fax Number : 207-874-2317
Provider Business Practice Location Address
First Line : 84 MARGINAL WAY
Second Line : SUITE 1000
City : PORTLAND
State : ME
Zip : 04101-2443
Country : US
Telephone Number : 207-347-2898
Fax Number : 207-553-1415
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : ROGER POITRAS
Credential :
Telephone Number : 207-347-2853
Provider Enumeration Date : 11/01/2006
Last Update Date : 05/12/2026

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Directions to “INTERMED, PA ” Practice Location

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