NPIMap

Organization Active NPI

Northern Maine Medical Center

Doing business as Northern Maine Medical Center Pharmacy

  • Community/Retail Pharmacy
  • Madawaska, ME
National Provider Identifier
1265417430
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH50001668 Issued in ME
Legal business name
NORTHERN MAINE MEDICAL CENTER
Doing business as
Northern Maine Medical Center Pharmacy
Practice address
104 Main St
Madawaska, ME 04756
Phone
(207) 728-7200
Fax
(207) 728-7227
NPI assigned
Dec 10, 2005
Last updated
Sep 15, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHERN MAINE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Authorized official

Name
Jeffrey Zewe
Title
Ceo
Phone
(207) 834-1411

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PH50001668 ME
Community/Retail Pharmacy 3336C0003X PH50001668 ME Primary
Long Term Care Pharmacy 3336L0003X PH50001668 ME

Addresses

Primary practice location

104 Main St
Madawaska, ME 04756

Mailing address

104 Main St
Madawaska, ME 04756-1437
Phone (207) 728-7200

Other identifiers 1

IdentifierTypeStateIssuer
2007830OtherNCPDP NUMBER

Other names 1

  • Northern Maine Medical Center Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180808001751 ME DME Supplier - Pharmacy 8426952987 Practice locations: Madawaska, ME

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
NMMC Pharmacy12 organizations share this tax ID, including this one
Part of
NMMC Pharmacy

Other organizations with this tax ID 11

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

Locations

104 Main St
Ste 101
Madawaska, ME 04756
Phone (207) 728-7200

NPI Registry JSON

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

{
    "created_epoch": "1134172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1265417430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MAIN ST",
            "city": "MADAWASKA",
            "state": "ME",
            "postal_code": "047561437",
            "telephone_number": "207-728-7200",
            "fax_number": "207-728-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MAIN ST",
            "city": "MADAWASKA",
            "state": "ME",
            "postal_code": "04756",
            "telephone_number": "207-728-7200",
            "fax_number": "207-728-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MAINE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN MAINE MEDICAL CENTER",
        "enumeration_date": "2005-12-10",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "ZEWE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-834-1411"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ME",
            "license": "PH50001668",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ME",
            "license": "PH50001668",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "ME",
            "license": "PH50001668",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "2007830",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Maine Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madawaska, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.