NPIMap

Katahdin Valley Health Center

Organization Active NPI Community/Retail Pharmacy · Millinocket, ME

NPI 1285156166 · NPPES record last updated Jul 12, 2017

Key facts

NPI
1285156166
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
KATAHDIN VALLEY HEALTH CENTER
Practice address
50 Summer St
Millinocket, ME 04462-1400
Phone
(207) 528-2285
Fax
(207) 528-2880
NPI assigned
Jul 12, 2017
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 12

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

Corporate family (same tax ID) 14

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

Practitioners 66

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 66

Laboratory certificates & supplier records

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Katahdin Valley Health Center
50 Summer St, Millinocket, ME 04462-1400 · (207) 447-4909		 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignment
Participating since Jan 1, 1994

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in ME

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20151208002051 ME Part B Supplier - Mass Immunization (Roster Biller Only) 4880659903 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Millinocket, ME; Patten, ME; Houlton, ME
O20171208000354 ME DME Supplier - Pharmacy 4880659903 Practice locations: Millinocket, ME

National Provider Directory

Tax ID family
Katahdin Valley Health Center (15 organizations share this tax ID)

Locations

50 Summer St
Millinocket, ME 04462
Phone (207) 723-6565

Specialties & licenses

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

Addresses

Primary practice location

50 Summer St
Millinocket, ME 04462-1400

Mailing address

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

Other providers in Millinocket, ME

All providers in Millinocket, ME · Community/Retail Pharmacy in Maine

Sources for this page

Verify at the official NPI Registry.