State of Maine

Practice location

Address

656 State St, Bangor, ME 04401-5609

Phone

(207) 287-7418

Fax

(207) 287-1862

Mailing address

109 Capitol Street Shs #11, Reimbursement Unit, Augusta, ME 04333-0011

Authorised official

Name

Carol Webb Cody

Title

Financial Manager

Phone

(207) 941-4192

Registered specialties

Registry record

NPI

1184020091

Entity type

Organization

NPI issued

5 Nov 2014

Record last updated

14 Jun 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.