Nephrogen Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

NEPHROGEN INC.

Practice address

39 Church St
Bethel, ME 04217-3809

Phone

(978) 799-8358

NPI assigned

May 14, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Demetrios S Maxim

Title

Founder and Ceo

Phone

(978) 799-8358

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1598387318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 CHURCH ST",
            "city": "BETHEL",
            "state": "ME",
            "postal_code": "042173809",
            "telephone_number": "978-799-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 CHURCH ST",
            "city": "BETHEL",
            "state": "ME",
            "postal_code": "042173809",
            "telephone_number": "978-799-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROGEN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "MAXIM",
        "authorized_official_first_name": "DEMETRIOS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "FOUNDER AND CEO",
        "authorized_official_telephone_number": "978-799-8358",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk R McClelland, M.S.W.
• Elizabeth H Meadows, MSW
• Meredith Moses, PA
• Mountain Motion Physical Therapy LLC
• Mountain View Eyecare, PA
• Joanne F Nicastro, MSN, NP
• Northern Vista Estate Services
• Susan Mackay Parker, LCPC
• Cara Pelletier, PHARM. D.
• Noretta E Peterson, CRNA

• Clinical Medical Laboratory in Bethel, ME
• Providers in Bethel, ME by specialty
• Clinical Medical Laboratory in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.