Provider Demographics
NPI:1558306498
Name:MMS SOUTHERN MAINE, INC.
Entity Type:Organization
Organization Name:MMS SOUTHERN MAINE, INC.
Other - Org Name:MAJORS MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TYRRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-729-6990
Mailing Address - Street 1:49 TOPSHAM FAIR MALL RD.
Mailing Address - Street 2:STE. 7
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1734
Mailing Address - Country:US
Mailing Address - Phone:207-729-6990
Mailing Address - Fax:207-729-8418
Practice Address - Street 1:49 TOPSHAM FAIR MALL RD
Practice Address - Street 2:STE 7
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1734
Practice Address - Country:US
Practice Address - Phone:207-729-6990
Practice Address - Fax:207-729-8418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME129340000Medicaid
ME129340000Medicaid
ME1065290001Medicare NSC