Basic Information
| Provider Information | |||||||||
| NPI: | 1548515224 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | YORK HOSPITAL | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | YORK HOSPITAL WELLS WALK IN CARE | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 039091011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2073512391 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 112 SANFORD RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | WELLS | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040905533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076465211 | ||||||||
| FaxNumber: | 2076418158 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2012 | ||||||||
| LastUpdateDate: | 07/18/2012 | ||||||||
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| AuthorizedOfficialLastName: | LABONTE | ||||||||
| AuthorizedOfficialFirstName: | ROBIN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2073512391 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | 37637 | ME | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.