Provider Demographics
NPI:1861488066
Name:MACHIAS HOME HEALTH, INC.
Entity Type:Organization
Organization Name:MACHIAS HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:JACQUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-255-8505
Mailing Address - Street 1:467 DUBLIN STREET
Mailing Address - Street 2:
Mailing Address - City:MACHIAS
Mailing Address - State:ME
Mailing Address - Zip Code:04654-9720
Mailing Address - Country:US
Mailing Address - Phone:207-255-8505
Mailing Address - Fax:207-255-3675
Practice Address - Street 1:467 DUBLIN STREET
Practice Address - Street 2:
Practice Address - City:MACHIAS
Practice Address - State:ME
Practice Address - Zip Code:04654-9720
Practice Address - Country:US
Practice Address - Phone:207-255-8505
Practice Address - Fax:207-255-3675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEWH70001087332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME116350001Medicaid
ME0141150001Medicare ID - Type UnspecifiedPROVIDER NUMBER