Provider Demographics
NPI:1619510047
Name:MAINEHEALTH
Entity Type:Organization
Organization Name:MAINEHEALTH
Other - Org Name:FMH PRIMARY CARE RHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-779-2263
Mailing Address - Street 1:111 FRANKLIN HEALTH CMNS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 FRANKLIN HEALTH CMNS
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6142
Practice Address - Country:US
Practice Address - Phone:207-860-4090
Practice Address - Fax:207-860-4098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAINEHEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-17
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health