Provider Demographics
NPI:1063136786
Name:CENTRAL MAINE MEDICAL CENTER
Entity type:Organization
Organization Name:CENTRAL MAINE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:ST PETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-795-7124
Mailing Address - Street 1:29 LOWELL ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7600
Mailing Address - Country:US
Mailing Address - Phone:603-795-2154
Mailing Address - Fax:
Practice Address - Street 1:685 SABATTUS ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-3831
Practice Address - Country:US
Practice Address - Phone:207-795-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL MAINE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care