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Organization

MAINEHEALTH

Active
Other names
MaineHealth Waldo Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO)
(207) 662-3538
Entity
Organization

Contact information

Practice address
118 NORTHPORT AVE, BELFAST, ME 04915-6009
(207) 338-2500
Mailing address
118 NORTHPORT AVE, BELFAST, ME 04915-6009

Taxonomy

Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
37189
ME
282NC0060X
Critical Access Hospital
Primary
37023
ME
3336I0012X
Institutional Pharmacy
36424
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101570000
ME
05
101570103
ME
01
2008058
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
08/21/2018
Last updated
10/23/2024
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