Provider Demographics
NPI:1073651576
Name:CENTRAL MAINE MEDICAL CENTER
Entity Type:Organization
Organization Name:CENTRAL MAINE MEDICAL CENTER
Other - Org Name:CMMC REHABILIATION CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:REGIONAL MGR PHYSICIAN PRAC. SUPPOR
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-795-5709
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7027
Mailing Address - Country:US
Mailing Address - Phone:207-795-5709
Mailing Address - Fax:
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7027
Practice Address - Country:US
Practice Address - Phone:207-795-5709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL MAINE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-05
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME20T024Medicare Oscar/Certification