| Aging Grace House Calls, Professional Corporation | |
|
21 E Summer St Bangor ME 04401-5513 | |
| (207) 573-0710 | |
| Not Available |
| Full Name | Aging Grace House Calls, Professional Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 21 E Summer St, Bangor, Maine |
| Authorized Official Name and Position | Kathryn M Mordino (CEO) |
| Authorized Official Contact | 6174357601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aging Grace House Calls, Professional Corporation 21 E Summer St Bangor ME 04401-5513 Ph: () - | Aging Grace House Calls, Professional Corporation 21 E Summer St Bangor ME 04401-5513 Ph: (207) 573-0710 |
| NPI Number | 1336919091 |
|---|---|
| Provider Enumeration Date | 01/04/2024 |
| Last Update Date | 02/26/2024 |
| Medicare PECOS PAC ID | 3072950260 |
|---|---|
| Medicare Enrollment ID | O20240323000166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336919091 | NPI | - | NPPES |
| Provider Name | Kathryn Marie Mordino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497092969 PECOS PAC ID: 3274770417 Enrollment ID: I20240323000158 |
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