Organization
LYMPHEDEMA ASSOC OF MAINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA JAMES DEVEREUX (PRESIDENT)
(207) 487-4966
Entity
Organization
Contact information
Practice address
715 HIGGINS ROAD, PITTSFIELD, ME 04967-0522
(207) 487-4966
(207) 487-4966
Mailing address
PO BOX 522, PITTSFIELD, ME 04967-0522
(207) 487-4966
(207) 487-4966
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050223
BCBS
ME
01
—
12Z050223ME01
ANTHEM BLUE CROSS/BLUE SH
—
01
—
7944648
AETNA
ME
01
—
AA57491
HARVARD PILGRIM
ME
Enumeration date
01/19/2007
Last updated
02/28/2008
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