Provider Demographics
NPI:1871547885
Name:EASTERN MAINE HOMECARE
Entity type:Organization
Organization Name:EASTERN MAINE HOMECARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOUCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-498-2578
Mailing Address - Street 1:885 UNION ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3083
Mailing Address - Country:US
Mailing Address - Phone:207-973-6550
Mailing Address - Fax:207-973-6557
Practice Address - Street 1:885 UNION ST
Practice Address - Street 2:SUITE 220
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3083
Practice Address - Country:US
Practice Address - Phone:207-973-6550
Practice Address - Fax:207-973-6557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36340251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA101740001Medicaid
ME201507Medicare Oscar/Certification