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MAINE COAST MOBILE MED LLC NPI 1710100839


NPI Information

NPI: 1710100839
Provider Name: MAINE COAST MOBILE MED, LLC
Classification: Radiologic Technologist - 247100000X
Entity Type: Organization
Address:
1576 HAMMOND ST STE C
BANGOR, ME
ZIP 04401
Phone: (207) 404-4894
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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 1710100839. 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) 404-4894
Fax: (207) 907-4911

The provider's authorized official is Phillip Forst .
The authorized official title is Owner and has the following contact phone number (207) 497-2996.

The enumeration date for this NPI number is 4/10/2007 and was last updated on 12/24/2019.


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
2335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging SupplierNo

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
2M161680OTHERMAINECIGNA
32328397OTHERMAINEAETNA
4MN3768OTHERMAINEHARVARD PILGRIM
5040509OTHERMAINEBCBS
6630001645OTHERMAINERAILROAD MEDICARE
7684929OTHERMAINETUFTS

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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