Provider Demographics
NPI:1477691467
Name:BRIDGTON HOSPITAL
Entity Type:Organization
Organization Name:BRIDGTON HOSPITAL
Other - Org Name:BRIDGTON HOSPITAL SWING BED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL MGR PHYSICIAN PRAC. SUPPOR
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-795-5709
Mailing Address - Street 1:10 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04009-1148
Mailing Address - Country:US
Mailing Address - Phone:207-795-5709
Mailing Address - Fax:
Practice Address - Street 1:10 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:BRIDGTON
Practice Address - State:ME
Practice Address - Zip Code:04009-1148
Practice Address - Country:US
Practice Address - Phone:207-795-5709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIDGTON HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-02
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME20Z310Medicare Oscar/Certification
ME200007Medicare PIN