Provider Demographics
NPI:1932902723
Name:MAINEHEALTH NEW HAMPSHIRE AMBULATORY CARE
Entity type:Organization
Organization Name:MAINEHEALTH NEW HAMPSHIRE AMBULATORY CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE CFO
Authorized Official - Prefix:
Authorized Official - First Name:LUGENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:INZANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-661-1346
Mailing Address - Street 1:24 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8311
Mailing Address - Country:US
Mailing Address - Phone:207-799-2400
Mailing Address - Fax:
Practice Address - Street 1:16 SEAVEY ST
Practice Address - Street 2:16 SEAVEY ST
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860
Practice Address - Country:US
Practice Address - Phone:207-779-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport