Provider Demographics
NPI:1437348794
Name:OXFORD HILLS INTERNAL MEDICINE GROUP
Entity Type:Organization
Organization Name:OXFORD HILLS INTERNAL MEDICINE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:F
Authorized Official - Last Name:LONGSTAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-743-7721
Mailing Address - Street 1:193 MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NORWAY
Mailing Address - State:ME
Mailing Address - Zip Code:04268-5645
Mailing Address - Country:US
Mailing Address - Phone:207-743-7721
Mailing Address - Fax:207-743-6306
Practice Address - Street 1:193 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268-5645
Practice Address - Country:US
Practice Address - Phone:207-743-7721
Practice Address - Fax:207-743-6306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEOX141518Medicare Oscar/Certification