NPIMap

Organization Active NPI

Maine Veterans' Homes

  • Long Term Care Pharmacy
  • Augusta, ME
National Provider Identifier
1700125267
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PH50001457 Issued in ME
Legal business name
MAINE VETERANS' HOMES
Doing business as
MVH Pharmacy (External Non VA Business)
Practice address
460 Civic Center Dr Ste 1
Augusta, ME 04330-7902
Phone
(207) 624-0200
Fax
(207) 624-0201
NPI assigned
Feb 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Authorized official

Name
Jim McQuaid
Title
Ceo
Phone
(207) 622-0075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X PH50001457 ME Primary

Addresses

Primary practice location

460 Civic Center Dr Ste 1
Augusta, ME 04330-7902

Mailing address

5 Community Dr
Suite 1
Augusta, ME 04330-8087
Phone (207) 624-0200

Other identifiers 1

IdentifierTypeStateIssuer
2008743OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • MVH Pharmacy (External Non VA Business) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241023002531 ME Part B Supplier - Mass Immunization (Roster Biller Only) 7416913397 Practice locations: Augusta, ME

Other NPIs with the same Medicare PAC ID 5

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D2192708Maine Veterans' Homes460 Civic Center Drive, Augusta, ME 04330Certificate of waiverSep 13, 2026

National Provider Directory

National Provider Directory

Locations

460 Civic Center Dr
Augusta, ME 04330
Phone (207) 624-0200

460 Civic Center Dr
Ste 1
Augusta, ME 04330
Phone (207) 624-0200

5 Community Dr
Ste 1
Augusta, ME 04330
Phone (207) 622-5814

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Maine Veterans' HomeScarborough, ME, CCN 205127 Skilled nursing facility Operational/Managerial Control Mar 31, 2009
Maine Veterans' HomeAugusta, ME, CCN 205126 Skilled nursing facility Operational/Managerial Control Mar 31, 2009
Maine Veterans' HomeBangor, ME, CCN 205185 Skilled nursing facility Operational/Managerial Control Mar 31, 2009
Maine Veterans' HomeSouth Paris, ME, CCN 205184 Skilled nursing facility Operational/Managerial Control Mar 31, 2009
Maine Veterans' HomeCaribou, ME, CCN 205151 Skilled nursing facility Operational/Managerial Control Mar 31, 2009

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1700125267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 COMMUNITY DR",
            "address_2": "SUITE 1",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308087",
            "telephone_number": "207-624-0200",
            "fax_number": "207-624-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 CIVIC CENTER DR STE 1",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307902",
            "telephone_number": "207-624-0200",
            "fax_number": "207-624-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE VETERANS' HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "MCQUAID",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-622-0075"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "ME",
            "license": "PH50001457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2008743",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MVH Pharmacy (External Non VA Business)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MVH Pharmacy (External Non VA Business)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.