Organization
DFD RUSSELL MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE A KANE-LEWIS (CEO)
(207) 524-3501
Entity
Organization
Contact information
Practice address
180 CHURCH HILL RD, SUITE 1, LEEDS, ME 04263-3418
(207) 524-3501
(207) 524-2459
Mailing address
180 CHURCH HILL RD, SUITE 1, LEEDS, ME 04263-3418
(207) 524-3501
(207) 524-2459
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168270000
—
ME
Enumeration date
10/18/2006
Last updated
02/09/2024
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