Provider Demographics
NPI:1568792224
Name:ST. MARY'S HEALTH SYSTEM
Entity Type:Organization
Organization Name:ST. MARY'S HEALTH SYSTEM
Other - Org Name:WORKMED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:BEVERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:207-777-8865
Mailing Address - Street 1:15 GRACELAWN RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6334
Mailing Address - Country:US
Mailing Address - Phone:207-753-3080
Mailing Address - Fax:207-753-3088
Practice Address - Street 1:15 GRACELAWN RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6334
Practice Address - Country:US
Practice Address - Phone:207-753-3080
Practice Address - Fax:207-753-3088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty