Provider Demographics
NPI:1760255244
Name:RURAL ME TELEHEALTH
Entity Type:Organization
Organization Name:RURAL ME TELEHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:THERIAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-290-3437
Mailing Address - Street 1:35 FURROUGH LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457-4317
Mailing Address - Country:US
Mailing Address - Phone:207-290-3437
Mailing Address - Fax:
Practice Address - Street 1:35 FURROUGH LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ME
Practice Address - Zip Code:04457-4317
Practice Address - Country:US
Practice Address - Phone:207-290-3437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care