Provider Demographics
NPI:1881974665
Name:BLUEWATER EMERGENCY PARTNERS OF CALAIS, LLC DBA: BLUEWATER URGENT CARE
Entity type:Organization
Organization Name:BLUEWATER EMERGENCY PARTNERS OF CALAIS, LLC DBA: BLUEWATER URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-522-8028
Mailing Address - Street 1:329 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-3310
Mailing Address - Country:US
Mailing Address - Phone:207-454-7521
Mailing Address - Fax:
Practice Address - Street 1:329 MAINE ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3310
Practice Address - Country:US
Practice Address - Phone:207-454-7521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty