Provider Demographics
NPI:1467468975
Name:LINCOLNHEALTH COVES EDGE
Entity Type:Organization
Organization Name:LINCOLNHEALTH COVES EDGE
Other - Org Name:MILES & ST. ANDREWS HOME HEALTH & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-633-8423
Mailing Address - Street 1:40 BELVEDERE RD
Mailing Address - Street 2:
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543-4550
Mailing Address - Country:US
Mailing Address - Phone:207-563-4592
Mailing Address - Fax:207-563-8652
Practice Address - Street 1:40 BELVEDERE RD
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4550
Practice Address - Country:US
Practice Address - Phone:207-563-4592
Practice Address - Fax:207-563-8652
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COVES EDGE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-01
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2744251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME207034Medicare Oscar/Certification