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Organization
MAINE COAST MOBILE MED. LLC
Active
Organization
MAINE COAST MOBILE MED. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP J. FORST RADIOGRAPHER (OWNER)
(207) 460-8882
Entity
Organization
Contact information
Practice address
1576 HAMMOND ST STE C, BANGOR, ME 04401-5751
(207) 460-8882
Mailing address
PO BOX 1393, ELLSWORTH, ME 04605-1393
(207) 460-8882
(207) 907-4911
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
RT3575
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132120000
—
ME
Enumeration date
01/22/2010
Last updated
03/17/2018
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