1932241270 NPI number — MORRISON CENTER

Table of content: (NPI 1932241270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932241270 NPI number — MORRISON CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MORRISON CENTER
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:
1932241270
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
60 CHAMBERLAIN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCARBOROUGH
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04074-9192
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-808-5033
Provider Business Mailing Address Fax Number:
207-808-5030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 CHAMBERLAIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCARBOROUGH
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04074-9192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-808-5033
Provider Business Practice Location Address Fax Number:
207-808-5030
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SLEEPER
Authorized Official First Name:
JESSICA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
207-808-5033

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  OT1539 , 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: 098571 . This is a "BCBS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 102560200 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 432373399 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102560002 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102560300 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 098548 . This is a "ANTHEM BCBS OT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 102560100 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102560400 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 005021 . This is a "ANTHEM BCBS SPEECH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 098571 . This is a "ANTHEM BCBS PT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 102560000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102560500 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".




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