# NORTHERN MAINE MEDICAL CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** St. John Valley LTC Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184645921
- **Authorized official:** MR. ALAIN BOIS (COO)
- **Authorized official phone:** (207) 834-3155

## Contact information

- **Practice address:** 182 MARKET STREET, SUITE 3, FORT KENT, ME 04743
- **Practice address phone:** (207) 834-2881
- **Practice address fax:** (207) 834-2082
- **Mailing address:** 194 EAST MAIN STREET, FORT KENT, ME 04743
- **Mailing address phone:** (207) 834-3155
- **Mailing address fax:** (207) 834-2949

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/21/2006
- **Last updated:** 03/25/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1184645921 | — | ME |
| 01 | — | 2037589 | PK | — |