Mt Abram Regional Health Center | |
25 Depot St Kingfield ME 04947-4208 | |
(207) 265-4555 | |
(207) 265-5004 |
Full Name | Mt Abram Regional Health Center |
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Speciality | Clinic/Center |
Location | 25 Depot St, Kingfield, Maine |
Authorized Official Name and Position | Constance R Coggins (PRESIDENT/CEO) |
Authorized Official Contact | 2078725610 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mt Abram Regional Health Center 25 Depot St Kingfield ME 04947-4208 Ph: (207) 265-4555 | Mt Abram Regional Health Center 25 Depot St Kingfield ME 04947-4208 Ph: (207) 265-4555 |
NPI Number | 1023082385 |
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Provider Enumeration Date | 02/14/2006 |
Last Update Date | 11/10/2014 |
Medicare PECOS PAC ID | 5496726523 |
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Medicare Enrollment ID | O20050830000534 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023082385 | NPI | - | NPPES |
137970102 | Medicaid | ME |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | E58728 (Maine) | Primary |
Provider Name | Lois C Hamel Corson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730135039 PECOS PAC ID: 4880650613 Enrollment ID: I20041203000464 |
Provider Name | Cynthia R Robertson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316911787 PECOS PAC ID: 7012952278 Enrollment ID: I20050628000443 |
Provider Name | Roy Miller |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700854361 PECOS PAC ID: 9032306212 Enrollment ID: I20101214000796 |
Provider Name | Christie King |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750631669 PECOS PAC ID: 5597915454 Enrollment ID: I20121031000034 |
Provider Name | Catherine Ann Yu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669604112 PECOS PAC ID: 6406993914 Enrollment ID: I20140627001780 |
Provider Name | Diane Zavotsky |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023128261 PECOS PAC ID: 8123099215 Enrollment ID: I20141104001286 |
Provider Name | Angela Kristoff |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1124570833 PECOS PAC ID: 3375825706 Enrollment ID: I20170120000081 |
Provider Name | Kelly Bragg |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386121978 PECOS PAC ID: 6608126602 Enrollment ID: I20180913000200 |