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Contact Information

MAINEHEALTH
22 BRAMHALL ST
PORTLAND, ME04102
 Phone: 207-662-6353
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MAINEHEALTH

NPI # 1164610242
LBN Legal business name MAINEHEALTH
Authorized official LUGENE INZANA - (SVP FINANCE/CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 10/15/2007
Last updated 04/01/2025 - More than a year ago
Identifiers
ME Medicaid 102500205
NH Medicaid 30216948
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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