Provider Demographics
NPI:1841448982
Name:ELDERCARE AT PARKVIEW
Entity type:Organization
Organization Name:ELDERCARE AT PARKVIEW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-729-9075
Mailing Address - Street 1:331 MAINE ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-3358
Mailing Address - Country:US
Mailing Address - Phone:207-729-9075
Mailing Address - Fax:207-729-5738
Practice Address - Street 1:331 MAINE ST
Practice Address - Street 2:SUITE 15
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3358
Practice Address - Country:US
Practice Address - Phone:207-729-9075
Practice Address - Fax:207-729-5738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013017207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEE61472Medicare UPIN