Provider Demographics
NPI:1508823741
Name:HOULTON REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:HOULTON REGIONAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-521-2152
Mailing Address - Street 1:20 HARTFORD ST
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-1891
Mailing Address - Country:US
Mailing Address - Phone:207-532-2900
Mailing Address - Fax:207-532-5974
Practice Address - Street 1:20 HARTFORD ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-1891
Practice Address - Country:US
Practice Address - Phone:207-532-2900
Practice Address - Fax:207-532-5974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME167890000Medicaid
ME201308Medicare Oscar/Certification