Mmc Family Practice Residency Program
LBN: Mainehealth
Mmc Family Practice Residency Program is an health care organization with primary practice located at 272 Congress St , Portland ME 04102. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Mainehealth can be contacted via phone (207) 874-2466, or through Inzana, Lugene Anthony via phone (207) 662-3538.
Contact Information
Primary practice address
272 Congress St
Portland ME 04102
Phone: (207) 874-2466
Fax: (207) 774-4625
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X |
Profile Details
| NPI number | 1225232606 |
|---|---|
| LBN Legal business name | Mainehealth |
| DBA Doing business as | Mmc Family Practice Residency Program |
| Authorized official | Inzana, Lugene Anthony |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 12th, 2007 |
| Last updated | Apr 24th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225232606 | NPPES |
| New Hampshire | MEDICAID | 30216370 |
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