Full Name | |
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Speciality | Clinic/Center |
Location | 1930 Medway Rd, Medway, Maine |
Authorized Official Name and Position | Nicole Morrison (CEO) |
Authorized Official Contact | 2077946700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1930 Medway Rd Medway ME 04460-3166 Ph: (207) 794-6700 | 1930 Medway Rd Medway ME 04460 Ph: (207) 794-6700 |
NPI Number | 1780842104 |
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Provider Enumeration Date | 06/02/2008 |
Last Update Date | 08/03/2018 |
Medicare PECOS PAC ID | 2769393180 |
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Medicare Enrollment ID | O20110121000239 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780842104 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |