Organization
EASTPORT HEALTH CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN KRAJEWSKI (EXECUTIVE DIRECTOR)
(207) 853-6001
Entity
Organization
Contact information
Practice address
30 BOYNTON ST, EASTPORT, ME 04631-1306
(207) 853-6001
(207) 853-4028
Mailing address
PO BOX H, EASTPORT, ME 04631-0909
(207) 853-6001
(207) 853-4028
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108830000
—
ME
01
—
7588080001
MEDICARE DME
—
Enumeration date
05/31/2006
Last updated
07/28/2020
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