Provider Demographics
NPI:1043467343
Name:MEMCARE LLC
Entity Type:Organization
Organization Name:MEMCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-522-9412
Mailing Address - Street 1:187 OLD STAGE RD
Mailing Address - Street 2:
Mailing Address - City:SANBORNVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03872-4627
Mailing Address - Country:US
Mailing Address - Phone:603-522-9412
Mailing Address - Fax:603-522-3234
Practice Address - Street 1:27 JUNE ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-2621
Practice Address - Country:US
Practice Address - Phone:207-490-0900
Practice Address - Fax:207-490-0902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME175662084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0005238Medicare PIN
NH000523801Medicare PIN