NPIMap

Organization Active NPI

Central Maine Medical Center

Doing business as CMMC Pharmacy

  • Community/Retail Pharmacy
  • Lewiston, ME
National Provider Identifier
1861433765
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH50001491 Issued in ME
Legal business name
CENTRAL MAINE MEDICAL CENTER
Doing business as
CMMC Pharmacy
Practice address
12 High St
Lewiston, ME 04240-7676
Phone
(207) 795-7177
Fax
(207) 795-7552
NPI assigned
Jun 10, 2006
Last updated
Jul 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Authorized official

Name
Kristin Chupka, DOCTORATENPI 1659547594
Title
Pharmacy Manager
Phone
(207) 795-8106

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH50001491 ME Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

12 High St
Lewiston, ME 04240-7676

Mailing address

CMMC Pharmacy
300 Main Street
Lewiston, ME 04240
Phone (207) 795-7177

Other names 1

  • CMMC Pharmacy Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140208000156 ME Part B Supplier - Mass Immunization (Roster Biller Only) 2567379563 Practice locations: Lewiston, ME
O20140527001343 ME DME Supplier - Pharmacy 2567379563 Practice locations: Lewiston, ME

Other NPIs with the same Medicare PAC ID 2

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Central Maine Medical Center12 High Street, Lewiston, ME 04240-7676(207) 795-2154 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
Central Maine Medical Center4 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

690 Minot Ave
#2
Auburn, ME 04210
Phone (207) 753-3456

690 Minot Ave
Ste 4
Auburn, ME 04210
Phone (207) 544-1078

12 High St
Ste 102
Lewiston, ME 04240
Phone (207) 783-2300

12 High St
Ste 200
Lewiston, ME 04240
Phone (207) 795-2935

76 High St
Lewiston, ME 04240
Phone (207) 795-2800

76 High St
Ste 300
Lewiston, ME 04240
Phone (207) 795-2800

77 Bates St
Ste 210
Lewiston, ME 04240
Phone (207) 753-7618

4 Horton Pl
Topsham, ME 04086
Phone (207) 795-6251

Practitioners & affiliated clinicians

Practitioners 136

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 136

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1861433765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CMMC PHARMACY",
            "address_2": "300 MAIN STREET",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "04240",
            "telephone_number": "207-795-7177",
            "fax_number": "207-795-7552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HIGH ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407676",
            "telephone_number": "207-795-7177",
            "fax_number": "207-795-7552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MAINE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "CHUPKA",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "207-795-8106",
        "authorized_official_credential": "DOCTORATE"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ME",
            "license": "PH50001491",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMMC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.