1861444226 NPI number — SMARTCARE INC

Table of content: (NPI 1861444226)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861444226 NPI number — SMARTCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SMARTCARE INC
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:
1861444226
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DIXFIELD
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04224-0220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-562-8048
Provider Business Mailing Address Fax Number:
207-562-7179

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 WELD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DIXFIELD
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04224-9515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-562-8048
Provider Business Practice Location Address Fax Number:
207-562-7179
Provider Enumeration Date:
05/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HEBERT
Authorized Official First Name:
LAUREN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/P.T.
Authorized Official Telephone Number:
207-562-8048

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT314 , 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)

  • Identifier: MNT385 . This is a "HARVARD PILGRIM GROUP" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: M20892 . This is a "CIGNA GROU NUMBER" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 779004 . This is a "TUFTS ID NUMBER GROUP" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1074990001 . This is a "DMERC GROUP NUMBER" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 2022587 . This is a "AETNA GROUP NUMBER" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".




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