Acadia Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1099966 Issued in ME

Legal business name

ACADIA MEDICAL SUPPLY INC

Practice address

104 Bangor St Ste B
Houlton, ME 04730-1662

Phone

(207) 532-7100

Fax

(207) 532-7200

NPI assigned

Aug 3, 2009

Organization subpart

Yes

Parent organization

ACADIA MEDICAL SUPPLY INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gregory J Crawford

Title

Ceo

Phone

(859) 441-8876

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Acadia Medical Supply Inc

  dba Quipt Home Medical Fort Fairfield

  • Durable Medical Equipment & Medical Supplies
  • Fort Fairfield, ME
  • NPI 1174671150

  7719199033

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Acadia Medical Supply Inc2 organizations share this tax ID, including this one

Part of

Acadia Medical Supply Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Acadia Medical Supply Inc

  dba Quipt Home Medical Fort Fairfield

  • Durable Medical Equipment & Medical Supplies
  • Fort Fairfield, ME
  • NPI 1174671150
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Acadia Medical Supply Inc

  dba Quipt Home Medical Fort Fairfield

  • Durable Medical Equipment & Medical Supplies
  • Fort Fairfield, ME
  • NPI 1174671150
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1144451535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BANGOR ST STE B",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301662",
            "telephone_number": "207-532-7100",
            "fax_number": "207-532-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BANGOR ST STE B",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301662",
            "telephone_number": "207-532-7100",
            "fax_number": "207-532-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADIA MEDICAL SUPPLY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACADIA MEDICAL SUPPLY INC",
        "enumeration_date": "2009-08-03",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "859-441-8876"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ME",
            "license": "1099966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134980000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eliza Anderson
• Thomas J. Anderson, D.M.D.
• Shahriar Anoushfar, D.O.

• Durable Medical Equipment & Medical Supplies in Houlton, ME
• Providers in Houlton, ME by specialty
• Durable Medical Equipment & Medical Supplies in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.