Organization
CASCO BAY ENDOSCOPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE MARIE DAIGLE CCP (BILLING MANAGER)
(207) 879-0094
Entity
Organization
Contact information
Practice address
25 LONG CREEK DR, SOUTH PORTLAND, ME 04106-2440
(207) 879-0094
(207) 879-0095
Mailing address
25 LONG CREEK DR, SOUTH PORTLAND, ME 04106-2440
(207) 879-0094
(207) 879-0095
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
36277
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135850000
—
ME
01
—
P00057120
RAILROAD MEDICARE
ME
Enumeration date
01/25/2006
Last updated
05/07/2008
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