Provider Demographics
NPI:1447204763
Name:MAINE COAST REGIONAL HEALTH FACILITIES
Entity Type:Organization
Organization Name:MAINE COAST REGIONAL HEALTH FACILITIES
Other - Org Name:MAINE COAST MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RONAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-664-5311
Mailing Address - Street 1:50 UNION ST
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1586
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:207-664-5498
Practice Address - Street 1:50 UNION ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1586
Practice Address - Country:US
Practice Address - Phone:207-664-5301
Practice Address - Fax:207-664-5498
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAINE COAST REGIONAL HEALTH FACILITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-20
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36279275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME20U050Medicare Oscar/Certification