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Contact Information

MAINEHEALTH
22 BRAMHALL ST
PORTLAND, ME04102-3134
 Phone: 207-871-4078
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for MAINEHEALTH

NPI Number 1073702288
LBN Legal business name MAINEHEALTH
Authorized official LUGENE INZANA - (ASSOCIATE CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 10/24/2007
Last updated 03/31/2025 - More than a year ago
Identifiers
ME Medicaid 119910022
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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