| Southern Maine Integrative Health Center, Llc | |
|
69 York St Suite 4 Kennebunk ME 04043-7153 | |
| (207) 985-3079 | |
| Not Available |
| Full Name | Southern Maine Integrative Health Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 69 York St, Kennebunk, Maine |
| Authorized Official Name and Position | Patrick Mulcahy (OWNER/DIRECTOR) |
| Authorized Official Contact | 2079853079 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Maine Integrative Health Center, Llc 69 York St Ste 4 Kennebunk ME 04043-7186 Ph: (207) 985-3079 | Southern Maine Integrative Health Center, Llc 69 York St Suite 4 Kennebunk ME 04043-7153 Ph: (207) 985-3079 |
| NPI Number | 1962588913 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 10/24/2007 |
| Medicare PECOS PAC ID | 3678675758 |
|---|---|
| Medicare Enrollment ID | O20070220000342 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962588913 | NPI | - | NPPES |
| ME2352 | Other | ME | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gloria I. Oppen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598957755 PECOS PAC ID: 7315288123 Enrollment ID: I20190404001203 |
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