Provider Demographics
NPI:1508931429
Name:WALDO COUNTY GENERAL HOSPITAL
Entity Type:Organization
Organization Name:WALDO COUNTY GENERAL HOSPITAL
Other - Org Name:ARTHUR JEWELL HEALTH CENTER AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:DRINKWATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-338-2500
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:BROOKS
Mailing Address - State:ME
Mailing Address - Zip Code:04921-0159
Mailing Address - Country:US
Mailing Address - Phone:207-722-3488
Mailing Address - Fax:207-722-3183
Practice Address - Street 1:55 REYNOLDS ROAD
Practice Address - Street 2:
Practice Address - City:BROOKS
Practice Address - State:ME
Practice Address - Zip Code:04921
Practice Address - Country:US
Practice Address - Phone:207-722-3488
Practice Address - Fax:207-722-3183
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WALDO COUNTY GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-24
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36424341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME101570300Medicaid
ME101570300Medicaid