Provider Demographics
NPI:1992106751
Name:MAINE SENIOR INSURANCE, LLC
Entity type:Organization
Organization Name:MAINE SENIOR INSURANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:RUSSEL
Authorized Official - Last Name:MINTHORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-590-6521
Mailing Address - Street 1:19 BUCKTHORN CIR
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-2474
Mailing Address - Country:US
Mailing Address - Phone:800-430-1302
Mailing Address - Fax:855-430-1302
Practice Address - Street 1:19 BUCKTHORN CIR
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-2474
Practice Address - Country:US
Practice Address - Phone:800-430-1302
Practice Address - Fax:855-430-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage