Provider Demographics
NPI:1851423008
Name:EASTERN MAINE HEALTHCARE SYSTEMS INLAND HOSPITAL
Entity type:Organization
Organization Name:EASTERN MAINE HEALTHCARE SYSTEMS INLAND HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-861-3338
Mailing Address - Street 1:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-0756
Mailing Address - Country:US
Mailing Address - Phone:207-474-2994
Mailing Address - Fax:207-858-0201
Practice Address - Street 1:344 LAKEWOOD RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:ME
Practice Address - Zip Code:04950-3015
Practice Address - Country:US
Practice Address - Phone:207-474-2994
Practice Address - Fax:207-858-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME116010201Medicaid
ME116010201Medicaid