Provider Demographics
NPI:1891888657
Name:MRH CORP.
Entity Type:Organization
Organization Name:MRH CORP.
Other - Org Name:NORTHERN LIGHT PRIMARY CARE CORINTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIENNEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-564-4251
Mailing Address - Street 1:897 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOVER FOXCROFT
Mailing Address - State:ME
Mailing Address - Zip Code:04426-1029
Mailing Address - Country:US
Mailing Address - Phone:207-564-4251
Mailing Address - Fax:207-564-4377
Practice Address - Street 1:492 MAIN ST
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:ME
Practice Address - Zip Code:04427-3273
Practice Address - Country:US
Practice Address - Phone:207-285-3435
Practice Address - Fax:207-564-1284
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MRH CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME208522OtherRHC #