Provider Demographics
NPI:1609837236
Name:GOODALL HEALTH PARTNERS
Entity Type:Organization
Organization Name:GOODALL HEALTH PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO GOODALL HOSPITAL
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:STROMSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-324-4310
Mailing Address - Street 1:PO BOX 233
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073
Mailing Address - Country:US
Mailing Address - Phone:207-459-7195
Mailing Address - Fax:207-459-7609
Practice Address - Street 1:27 JUNE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-2621
Practice Address - Country:US
Practice Address - Phone:207-459-7195
Practice Address - Fax:207-459-7609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME=========Medicaid
ME=========Medicaid