Provider Demographics
NPI:1417136581
Name:RESPIRATORY CARE OF MAINE PA
Entity Type:Organization
Organization Name:RESPIRATORY CARE OF MAINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-262-1881
Mailing Address - Street 1:358 BROADWAY STE 202
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3929
Mailing Address - Country:US
Mailing Address - Phone:207-262-1881
Mailing Address - Fax:207-990-3649
Practice Address - Street 1:358 BROADWAY STE 202
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3929
Practice Address - Country:US
Practice Address - Phone:207-262-1881
Practice Address - Fax:207-990-3649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013306225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEC65733Medicare UPIN
MEME0677Medicare PIN