Provider Demographics
NPI:1699860270
Name:YORK HOSPITAL DBA COASTAL OB-GYN, LLC
Entity Type:Organization
Organization Name:YORK HOSPITAL DBA COASTAL OB-GYN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LABONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-351-2391
Mailing Address - Street 1:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04098
Mailing Address - Country:US
Mailing Address - Phone:207-854-1544
Mailing Address - Fax:207-854-1516
Practice Address - Street 1:112 SANFORD ROAD
Practice Address - Street 2:SUITE 2A
Practice Address - City:WELLS
Practice Address - State:ME
Practice Address - Zip Code:04090
Practice Address - Country:US
Practice Address - Phone:207-641-8044
Practice Address - Fax:207-641-8169
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YORK HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-03
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432208399Medicaid
ME1649364233OtherJENNIFER EATON DO IND NPI
ME1124026208OtherMARK C TORRES DO IND NPI
ME1861587305OtherSTEPHEN WAGONER MD IND NP
ME1154430023OtherJANE ADAMS APRN IND NPI
ME1699860270OtherGROUP NPI #
ME432208399Medicaid
ME1124026208OtherMARK C TORRES DO IND NPI