Provider Demographics
NPI:1275716326
Name:PROMPTCARE MAINE LLC
Entity Type:Organization
Organization Name:PROMPTCARE MAINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-653-3861
Mailing Address - Street 1:980 FOREST AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-3336
Mailing Address - Country:US
Mailing Address - Phone:207-797-5490
Mailing Address - Fax:207-797-5491
Practice Address - Street 1:980 FOREST AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-3336
Practice Address - Country:US
Practice Address - Phone:207-797-5490
Practice Address - Fax:207-797-5491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2072401900020332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME6083060001Medicare NSC