Organization
INTERMED, PA
Active
Parent organization
INTERMED PA
Other names
InterMed Ambulatory Surgery Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMED PA
Authorized official
ROGER POITRAS (CHIEF EXECUTIVE OFFICER)
(207) 347-2853
Entity
Organization
Contact information
Practice address
84 MARGINAL WAY, SUITE 1000, PORTLAND, ME 04101-2443
(207) 347-2898
(207) 553-1415
Mailing address
100 GANNETT DRIVE, SUITE C, SOUTH PORTLAND, ME 04106
(207) 347-2947
(207) 874-2317
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
38444
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126390100
—
ME
01
—
P02306616
RAILROAD MEDICARE
ME
Enumeration date
11/01/2006
Last updated
05/12/2026
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