Lymphormation Center

Primary specialty

SpecialistTaxonomy code 174400000X

License

OT1547 Issued in ME

Legal business name

LYMPHORMATION CENTER

Practice address

675 Main St
Marketplace Mall the Commons
Lewiston, ME 04240-5802

Phone

(207) 786-6989

Fax

(207) 786-6990

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Debra Anne Matthews

Title

President

Phone

(207) 786-6989

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639203458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 MAIN ST",
            "address_2": "MARKETPLACE MALL THE COMMONS",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405802",
            "telephone_number": "207-786-6989",
            "fax_number": "207-786-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 MAIN ST",
            "address_2": "MARKETPLACE MALL THE COMMONS",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405802",
            "telephone_number": "207-786-6989",
            "fax_number": "207-786-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYMPHORMATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "DEBRA ANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-786-6989",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "ME",
            "license": "OT1547",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "ME",
            "license": "PT2735",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Specialist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.