Provider Demographics
NPI:1124207162
Name:JANE GARFIELD DBA MEDNOW CLINIC ELLSWORTH
Entity Type:Organization
Organization Name:JANE GARFIELD DBA MEDNOW CLINIC ELLSWORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-667-4655
Mailing Address - Street 1:5 LONG LN
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1734
Mailing Address - Country:US
Mailing Address - Phone:207-667-4655
Mailing Address - Fax:207-667-2650
Practice Address - Street 1:5 LONG LN
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1734
Practice Address - Country:US
Practice Address - Phone:207-667-4655
Practice Address - Fax:207-667-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME4521710001Medicare NSC
MEMM8826Medicare PIN