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 | 332BX2000X | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies | | | 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 | 12Y008519ME01 | OTHER | NEW HAMPSHIRE | ANTHEM |
| 2 | 1659305845 | OTHER | MAINE | HARVARD PILGRIM |
| 3 | ========= | OTHER | MAINE | EBPA/CBA |
| 4 | 12Z048468ME01 | OTHER | MAINE | ANTHEM |
| 5 | 1659305845 | OTHER | MAINE | MEDICARE ADVANTAGE PLAN |
| 6 | ========= | OTHER | MAINE | MAIL HANDLERS |
| 7 | 30765245 | MEDICAID | NEW HAMPSHIRE | |
| 8 | ========= | OTHER | MAINE | PATIENT ADVOCATES |
| 9 | 1659305845 | OTHER | MAINE | UNITED HEALTH CARE |
| 10 | 431787200 | MEDICAID | MAINE | |
| 11 | 30765245 | OTHER | MAINE | NEW HAMPSHIRE MEDICAID |
| 12 | ========= | OTHER | MAINE | MARTINS POINT HEALTH CARE |
| 13 | ========= | OTHER | MAINE | MARTINS POINT HEALTHCARE |
| 14 | ========= | OTHER | MAINE | PATRIOT HEALTH |
| 15 | ========= | OTHER | MAINE | GEHA |
| 16 | 1659305845 | OTHER | MAINE | AETNA |
| 17 | 1659305845 | OTHER | MAINE | FIRST HEALTH NETWORK |
| 18 | ========= | OTHER | MAINE | BEACON HOSPICE |
| 19 | ========= | OTHER | MAINE | HOMELINK |
| 20 | 4962810001 | MEDICARE NSC | MAINE | |
