NPIMap

Organization Active NPI

Kennebec Pharmacy and Home Care LLC

Doing business as Kennebec Pharmacy & Home Care

  • Durable Medical Equipment & Medical Supplies
  • Rockport, ME
National Provider Identifier
1710992342
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
KENNEBEC PHARMACY AND HOME CARE LLC
Doing business as
Kennebec Pharmacy & Home Care
Practice address
839 Commercial St Ste 2
Rockport, ME 04856-4243
Phone
(207) 594-0888
Fax
(207) 594-0889
NPI assigned
Jul 30, 2006
Last updated
Sep 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Authorized official

Name
Ted Nathan Trebilcock
Title
Controller
Phone
(207) 626-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

839 Commercial St Ste 2
Rockport, ME 04856-4243

Mailing address

43 Leighton Rd
Augusta, ME 04330-7705
Phone (207) 626-2726

Other identifiers 2

IdentifierTypeStateIssuer
129010002MedicaidME
2037593OtherPK

Other names 1

  • KENNEBEC PHARMACY & HOME CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930046632 ME DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company With Registered PharmacistDME Supplier - Medical Supply CompanyDME Supplier - Orthotic Personnel 7214057546 Practice locations: Rockport, ME
O20151118000564 ME Part B Supplier - Mass Immunization (Roster Biller Only) 7214057546 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Augusta, ME; Rockport, ME; Brunswick, ME

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 4

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

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Kennebec Pharmacy & Home Care LLC839 Commercial St, Rockport, ME 04856-4243(207) 594-0888 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|External Infusion Pumps and/or Supplies|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Canes and/or Crutches|Patient Lifts|P… Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Kennebec Pharmacy and Home Care LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

839 Commercial St
Ste 2
Rockport, ME 04856
Phone (207) 594-0888

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1710992342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 LEIGHTON RD",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307705",
            "telephone_number": "207-626-2726",
            "fax_number": "207-626-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 COMMERCIAL ST STE 2",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564243",
            "telephone_number": "207-594-0888",
            "fax_number": "207-594-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEBEC PHARMACY AND HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "TREBILCOCK",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "207-626-2726"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129010002",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2037593",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KENNEBEC PHARMACY & HOME CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KENNEBEC PHARMACY & HOME CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockport, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.