NPIMap

Organization Active NPI

Katahdin Valley Health Center

  • Community/Retail Pharmacy
  • Dover Foxcroft, ME
National Provider Identifier
1194428656
Registry record updated Apr 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KATAHDIN VALLEY HEALTH CENTER
Practice address
188 Summer St Ste a
Dover Foxcroft, ME 04426-1129
Phone
(207) 528-2285
Fax
(207) 528-2880
NPI assigned
Mar 23, 2023
Last updated
Apr 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2023

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

Authorized official

Name
Claudette Humphrey
Title
Ceo
Phone
(207) 528-2285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

188 Summer St Ste a
Dover Foxcroft, ME 04426-1129

Mailing address

529 S Patten Rd
Patten, ME 04765-3007
Phone (207) 528-2285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250114000245 ME DME Supplier - Pharmacy 4880659903 Practice locations: Dover Foxcroft, ME

Other NPIs with the same Medicare PAC ID 12

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Katahdin Valley Health Center188 Summer St, Dover Foxcroft, ME 04426-1129(207) 538-3700 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1994
Katahdin Valley Health Center188 Summer St, Dover Foxcroft, ME 04426-1129(207) 538-3700 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 1994

National Provider Directory

National Provider Directory
Tax ID family
Katahdin Valley15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

188 Summer St
Ste A
Dover Foxcroft, ME 04426

188 Summer St
Ste B
Dover Foxcroft, ME 04426

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682726400000",
    "number": "1194428656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 S PATTEN RD",
            "city": "PATTEN",
            "state": "ME",
            "postal_code": "047653007",
            "telephone_number": "207-528-2285",
            "fax_number": "207-528-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 SUMMER ST STE A",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044261129",
            "telephone_number": "207-528-2285",
            "fax_number": "207-528-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATAHDIN VALLEY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-04-29",
        "certification_date": "2023-04-29",
        "status": "A",
        "authorized_official_last_name": "HUMPHREY",
        "authorized_official_first_name": "CLAUDETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-528-2285"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover Foxcroft, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2023; 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.