Provider Demographics
NPI:1598152035
Name:MAINE COAST REGIONAL HEALTH FACILITIES
Entity Type:Organization
Organization Name:MAINE COAST REGIONAL HEALTH FACILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:THERRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-664-5301
Mailing Address - Street 1:50 UNION ST
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1534
Mailing Address - Country:US
Mailing Address - Phone:207-664-5304
Mailing Address - Fax:207-664-5305
Practice Address - Street 1:50 UNION ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1534
Practice Address - Country:US
Practice Address - Phone:207-664-5304
Practice Address - Fax:207-664-5305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty