# MAINEHEALTH

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MAINEHEALTH
- **Other names:** Angel Ambulance
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508342643
- **Legal business name:** MAINEHEALTH
- **Authorized official:** LUGENE ANTHONY INZANA (ASSOCIATE CFO, MAINEHEALTH)
- **Authorized official phone:** (207) 662-3538

## Contact information

- **Practice address:** 22 BRAMHALL ST, PORTLAND, ME 04102-3134
- **Practice address phone:** (207) 662-0111
- **Mailing address:** 22 BRAMHALL ST, PORTLAND, ME 04102-3134
- **Mailing address phone:** (207) 662-0111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 1050 | ME | Yes |

## Other

- **Enumeration date:** 07/12/2018
- **Last updated:** 05/11/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 102500000 | — | ME |
| 01 | — | 200009000025 | ANTHEM BLUE CROSS PROVIDER \# | ME |