Provider Demographics
NPI:1295993616
Name:HEALTH ACCESS NETWORK, INC.
Entity type:Organization
Organization Name:HEALTH ACCESS NETWORK, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-794-6700
Mailing Address - Street 1:9 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457-1216
Mailing Address - Country:US
Mailing Address - Phone:207-794-6700
Mailing Address - Fax:207-794-8792
Practice Address - Street 1:9 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:LINCOLN
Practice Address - State:ME
Practice Address - Zip Code:04457
Practice Address - Country:US
Practice Address - Phone:207-794-6700
Practice Address - Fax:207-794-8792
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH ACCESS NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-02
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME161040200Medicaid