1861479578 NPI number — YORK HOSPITAL SKILLED NURSING FACILITY

Table of content: (NPI 1861479578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861479578 NPI number — YORK HOSPITAL SKILLED NURSING FACILITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YORK HOSPITAL SKILLED NURSING FACILITY
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:
1861479578
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:
15 HOSPITAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORK
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
03909-1011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-363-4321
Provider Business Mailing Address Fax Number:
207-363-3858

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
03909-1011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-363-4321
Provider Business Practice Location Address Fax Number:
207-363-3858
Provider Enumeration Date:
12/23/2005

Additional Information

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  36286 , 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: 200020 . This is a "BCNH ANESTHESIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 99200020 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: M10500 . This is a "CIGNA HEALTHSOURCE NH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200020 . This is a "BCNH IP AND OP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200020 . This is a "BCNH ER" identifier . This identifiers is of the category "OTHER".
  • Identifier: IYOK200020 . This is a "MATTHEW THORNTON BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: M10500 . This is a "CIGNA HEALTHSOURCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 900273 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 800373 . This is a "BCNH CARDIAC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200020 . This is a "MATTHEW THORNTON HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 921444 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10022603 . This is a "CAPITAL DISTRICT PHYSICIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200020 . This is a "BCNH ONCOLOGY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 62463 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: E000211 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200020000054 . This is a "BCME BCMA" identifier . This identifiers is of the category "OTHER".




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