Provider Demographics
NPI:1083636039
Name:MIDCOAST HOSPITAL
Entity Type:Organization
Organization Name:MIDCOAST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-373-6027
Mailing Address - Street 1:1356A WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2847
Mailing Address - Country:US
Mailing Address - Phone:207-443-6702
Mailing Address - Fax:207-443-2317
Practice Address - Street 1:1356A WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2847
Practice Address - Country:US
Practice Address - Phone:207-443-6702
Practice Address - Fax:207-443-2317
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDCOAST HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-25
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEME0579Medicare PIN