Provider Demographics
NPI:1932268026
Name:MAINEGENERAL HEALTH
Entity Type:Organization
Organization Name:MAINEGENERAL HEALTH
Other - Org Name:HEALTHREACH NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTING AND FINANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-872-1639
Mailing Address - Street 1:10 WATER ST
Mailing Address - Street 2:STE 306
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6559
Mailing Address - Country:US
Mailing Address - Phone:207-861-3488
Mailing Address - Fax:207-861-3470
Practice Address - Street 1:10 WATER ST
Practice Address - Street 2:STE 306
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6559
Practice Address - Country:US
Practice Address - Phone:207-861-3488
Practice Address - Fax:207-861-3470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME221903 AND 230503251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM7704Medicare Oscar/Certification