Provider Demographics
NPI:1386728434
Name:LOUIS J. PARADIS INC.
Entity type:Organization
Organization Name:LOUIS J. PARADIS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:PARADIS
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:207-834-4204
Mailing Address - Street 1:62 W MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-1244
Mailing Address - Country:US
Mailing Address - Phone:207-834-4204
Mailing Address - Fax:207-834-2870
Practice Address - Street 1:62 W MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-1244
Practice Address - Country:US
Practice Address - Phone:207-834-4204
Practice Address - Fax:207-834-2870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPH50001215332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME2007741OtherNABP
MEBL9072783OtherDEA
ME1312840003Medicare ID - Type Unspecified