Basic Information
| Provider Information | |||||||||
| NPI: | 1710150966 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BERWICK WALK IN CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 039091099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2073512398 | ||||||||
| FaxNumber: | 2073512411 | ||||||||
| Practice Location | |||||||||
| Address1: | 4 DANA DR | ||||||||
| Address2: | |||||||||
| City: | BERWICK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 039012767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076986700 | ||||||||
| FaxNumber: | 2076986709 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2008 | ||||||||
| LastUpdateDate: | 04/09/2008 | ||||||||
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| AuthorizedOfficialLastName: | LABONTE | ||||||||
| AuthorizedOfficialFirstName: | ROBIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2073512391 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | YORK HOSPITAL | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | N | Ambulatory Health Care Facilities | Clinic/Center | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.