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MAINE COAST MOBILE MED. LLC NPI 1184955692


NPI Information

NPI: 1184955692
Provider Name: MAINE COAST MOBILE MED. LLC
Classification: Radiologic Technologist - 247100000X
Entity Type: Organization

CLIA Number: 20D0089815

Address:
1576 HAMMOND ST STE C
BANGOR, ME
ZIP 04401
Phone: (207) 460-8882
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MAINE COAST MOBILE MED. LLC is a radiologic technologist in Bangor, ME. The provider is an individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. MAINE COAST MOBILE MED. LLC NPI is 1184955692. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1576 HAMMOND ST STE C
BANGOR, ME
ZIP 04401-751
Phone: (207) 460-8882

The provider's authorized official is Philip J. Forst .
The authorized official title is Owner and has the following contact phone number (207) 460-8882.

The CLIA number assigned to this NPI record is 20D0089815 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 1/22/2010 and was last updated on 3/17/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1247100000XRadiologic TechnologistRT3575MAINEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1132120000MEDICAIDMAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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