Provider Demographics
NPI:1609057900
Name:HOPE HEALTH PC
Entity Type:Organization
Organization Name:HOPE HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:207-236-2201
Mailing Address - Street 1:77 ELM ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-1904
Mailing Address - Country:US
Mailing Address - Phone:207-236-2201
Mailing Address - Fax:207-236-2203
Practice Address - Street 1:77 ELM ST
Practice Address - Street 2:SUITE 4
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1904
Practice Address - Country:US
Practice Address - Phone:207-236-2201
Practice Address - Fax:207-236-2203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER030681261QP2300X
MER028675261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEHONG0102OtherMEDICARE PRACTICE NUMBER
MEUX6262OtherMEDICARE PROVIDER NUMBER
MEUX6263OtherMEDICARE PROVIDER NUMBER
MEUX6263OtherMEDICARE PROVIDER NUMBER
MES85054Medicare UPIN