Provider Demographics
NPI:1134391808
Name:GREAT WORKS FAMILY PRACTICE
Entity type:Organization
Organization Name:GREAT WORKS FAMILY PRACTICE
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 1:57 PORTLAND ST
Mailing Address - Street 2:STE 2A
Mailing Address - City:SOUTH BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03908-1203
Mailing Address - Country:US
Mailing Address - Phone:207-384-9212
Mailing Address - Fax:207-384-2008
Practice Address - Street 1:57 PORTLAND ST
Practice Address - Street 2:STE 2A
Practice Address - City:SOUTH BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03908-1203
Practice Address - Country:US
Practice Address - Phone:207-384-9212
Practice Address - Fax:207-389-9212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YORK HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty