Provider Demographics
NPI:1568701324
Name:HEALTH ACCESS NETWORK, INC.
Entity Type:Organization
Organization Name:HEALTH ACCESS NETWORK, INC.
Other - Org Name:HEALTH ACCESS NETWORK LEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-794-6700
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457-0099
Mailing Address - Country:US
Mailing Address - Phone:207-794-6700
Mailing Address - Fax:207-794-6777
Practice Address - Street 1:21 WINN RD
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:ME
Practice Address - Zip Code:04455
Practice Address - Country:US
Practice Address - Phone:207-794-6700
Practice Address - Fax:207-794-6777
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH ACCESS NETWORK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-13
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM9709Medicare Oscar/Certification
ME201914Medicare PIN