1528085586 NPI number — NEPHROLOGY ASSOCIATES OF CENTRAL MAINE

Table of content: MISS SHIRLEY P HO M.S. (NPI 1265554679)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528085586 NPI number — NEPHROLOGY ASSOCIATES OF CENTRAL MAINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEPHROLOGY ASSOCIATES OF CENTRAL MAINE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528085586
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
710 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEWISTON
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04240-5801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-783-1449
Provider Business Mailing Address Fax Number:
207-777-3865

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
710 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTON
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04240-5801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-783-1449
Provider Business Practice Location Address Fax Number:
207-777-3865
Provider Enumeration Date:
07/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KILGORE
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
207-783-1449

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com