ACADIA MEDICAL ARTS AMBULATORY SURGICAL SUITE NPI 1407867583

NPI Information

NPI: 1407867583
Provider Name: ACADIA MEDICAL ARTS AMBULATORY SURGICAL SUITE
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 20D0877978

Address:
73 RIDGEWOOD DRIVE
BANGOR, ME
ZIP 04401
Phone: (207) 990-0928
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ACADIA MEDICAL ARTS AMBULATORY SURGICAL SUITE is an ambulatory surgical clinic center in Bangor, ME. ACADIA MEDICAL ARTS AMBULATORY SURGICAL SUITE NPI is 1407867583. The provider is registered as an organization entity type.

The provider's business location address is:

73 RIDGEWOOD DRIVE
BANGOR, ME
ZIP 04401
Phone: (207) 990-0928
Fax: (207) 990-3844

The provider's authorized official is Melanie Sibley .
The authorized official title is Administrator and has the following contact phone number (207) 262-6974.

The CLIA number assigned to this NPI record is 20D0877978 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/11/2006 and was last updated on 2/17/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	20C0001007	MAINE	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	490001551	OTHER	MAINE	RR MEDICARE PIN
2	100342300	OTHER	MAINE	US DEPT OF LABOR
3	5444660	OTHER	MAINE	AETNA
4	902425	OTHER	MAINE	HARVARD PILGRIM
5	121350000	MEDICAID	MAINE
6	201007001007	OTHER	MAINE	BLUE CROSS/BLUE SHIELD

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: 4/28/2024

NPI Synchronization or Removal

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