1699860270 NPI number — YORK HOSPITAL DBA COASTAL OB-GYN, LLC

Table of content: (NPI 1699860270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699860270 NPI number — YORK HOSPITAL DBA COASTAL OB-GYN, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YORK HOSPITAL DBA COASTAL OB-GYN, LLC
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:
1699860270
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 810
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTBROOK
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04098
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-854-1544
Provider Business Mailing Address Fax Number:
207-854-1516

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 SANFORD ROAD
Provider Second Line Business Practice Location Address:
SUITE 2A
Provider Business Practice Location Address City Name:
WELLS
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-641-8044
Provider Business Practice Location Address Fax Number:
207-641-8169
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LABONTE
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
207-351-2391

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 432208399 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649364233 . This is a "JENNIFER EATON DO IND NPI" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1124026208 . This is a "MARK C TORRES DO IND NPI" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1861587305 . This is a "STEPHEN WAGONER MD IND NP" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1154430023 . This is a "JANE ADAMS APRN IND NPI" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1699860270 . This is a "GROUP NPI #" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".




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