Provider Demographics
NPI:1043342827
Name:ACUPUNCTURE & HERBS, INC.
Entity Type:Organization
Organization Name:ACUPUNCTURE & HERBS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:KLOBAS
Authorized Official - Suffix:
Authorized Official - Credentials:M AC
Authorized Official - Phone:207-621-0985
Mailing Address - Street 1:228 WATER ST
Mailing Address - Street 2:
Mailing Address - City:HALLOWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04347-1335
Mailing Address - Country:US
Mailing Address - Phone:207-621-0985
Mailing Address - Fax:207-621-0985
Practice Address - Street 1:228 WATER ST
Practice Address - Street 2:
Practice Address - City:HALLOWELL
Practice Address - State:ME
Practice Address - Zip Code:04347-1335
Practice Address - Country:US
Practice Address - Phone:207-621-0985
Practice Address - Fax:207-621-0985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC105171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME022750OtherANTHEM BCBS