Provider Demographics
NPI:1083863864
Name:ST JOSEPH COLLEGE
Entity Type:Organization
Organization Name:ST JOSEPH COLLEGE
Other - Org Name:ST. JOSEPHS OF MAINE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUE ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-893-6634
Mailing Address - Street 1:278 WHITES BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STANDISH
Mailing Address - State:ME
Mailing Address - Zip Code:04084-5236
Mailing Address - Country:US
Mailing Address - Phone:207-893-6634
Mailing Address - Fax:207-893-7865
Practice Address - Street 1:278 WHITES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:STANDISH
Practice Address - State:ME
Practice Address - Zip Code:04084-5236
Practice Address - Country:US
Practice Address - Phone:207-893-6634
Practice Address - Fax:207-893-7865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty