National Provider Identifier Database

MAINE COAST MOBILE MED LLC
Radiologic Technologist

A medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and nonionizing radiation.


Contact Information

MAINE COAST MOBILE MED, LLC
1576 HAMMOND ST STE C
BANGOR, ME04401-5751
Phone: 207-404-4894
Fax: 207-907-4911
Website:
Specialty Taxonomy Code
* Radiologic Technologist 247100000X
Portable Xray Supplier 335V00000X

* Indicates primary specialty

NPI Profile & details for MAINE COAST MOBILE MED, LLC

NPI Number 1710100839
Legal business name
LBN
MAINE COAST MOBILE MED, LLC
Authorized official PHILLIP FORST - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 04/10/2007
Last updated 12/24/2019 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • ME License #: RT3575
  • ME Medicaid: 132120000
  • ME Other: 2328397 AETNA
  • ME Other: 040509 BCBS
  • ME Other: M161680 CIGNA
  • ME Other: MN3768 HARVARD PILGRIM
  • ME Other: 630001645 RAILROAD MEDICARE
  • ME Other: 684929 TUFTS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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