Basic Information
| Provider Information | |||||||||
| NPI: | 1528359841 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STEPHENS MEMORIAL HOSPITAL ASSOCIATION | ||||||||
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| OtherOrganizationName: | OXFORD HILLS FAMILY PRACTICE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 181 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | NORWAY | ||||||||
| State: | ME | ||||||||
| PostalCode: | 042685664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077435933 | ||||||||
| FaxNumber: | 2077431566 | ||||||||
| Practice Location | |||||||||
| Address1: | 34 WINTER ST | ||||||||
| Address2: | |||||||||
| City: | NORWAY | ||||||||
| State: | ME | ||||||||
| PostalCode: | 042685620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077438031 | ||||||||
| FaxNumber: | 2077436672 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2011 | ||||||||
| LastUpdateDate: | 10/15/2012 | ||||||||
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| AuthorizedOfficialLastName: | COX | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | SR VP FISCAL | ||||||||
| AuthorizedOfficialTelephone: | 2077435933 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | STEPHENS MEMORIAL HOSPITAL ASSOCIATION | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | 37353 | ME | N | Hospitals | General Acute Care Hospital | Critical Access | 363LF0000X | 37353 | ME | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 207Q00000X | 37353 | ME | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.