Provider Demographics
NPI:1376546143
Name:CALAIS COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:CALAIS COMMUNITY HOSPITAL
Other - Org Name:CALAIS COMMUNITY SWING BEDS
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LYNNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-255-0269
Mailing Address - Street 1:24 HOSPITAL LN
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1329
Mailing Address - Country:US
Mailing Address - Phone:207-454-7521
Mailing Address - Fax:207-454-3616
Practice Address - Street 1:24 HOSPITAL LN
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1329
Practice Address - Country:US
Practice Address - Phone:207-454-7521
Practice Address - Fax:207-454-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36210275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0012304OtherAETNA
ME101960100Medicaid
ME0439887OtherCIGNA
ME010211783OtherTRICARE
ME000008OtherANTHEM BLUE CROSS
ME900800OtherHARVARD PILGRIM
ME20Z305Medicare Oscar/Certification