Provider Demographics
NPI:1356633655
Name:SOUTHERN MAINE HEALTH CARE-WORKWELL
Entity type:Organization
Organization Name:SOUTHERN MAINE HEALTH CARE-WORKWELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-490-7018
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-283-7600
Mailing Address - Fax:207-283-7606
Practice Address - Street 1:13 JULY ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-1909
Practice Address - Country:US
Practice Address - Phone:207-490-7099
Practice Address - Fax:207-490-5560
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN MAINE HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-05
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital