Active NPI
Kennebec Pharmacy and Home Care, LLC
Doing business as Kennebce Pharmacy & Home Care
- Durable Medical Equipment & Medical Supplies
- South Portland, ME
National Provider Identifier
1962098848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- KENNEBEC PHARMACY AND HOME CARE, LLC
- Doing business as
- Kennebce Pharmacy & Home Care
Kennebec Pharmacy & Home Care, LLC - Practice address
- 12 Atlantic PL Unit a-12
South Portland, ME 04106-2316 - Phone
- (207) 626-2130
- Fax
- (207) 502-8030
- NPI assigned
- Dec 15, 2020
- Last updated
- Apr 1, 2026
- Organization subpart
- Yes
- Parent organization
- KENNEBEC PHARMACY & HOME CARE, LLC
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
12 Atlantic PL Unit a-12
South Portland, ME 04106-2316
Mailing address
43 Leighton Rd
Augusta, ME 04330-7705
Phone (207) 626-2726
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129010001 | Medicaid | ME |
Other names 2
- Kennebce Pharmacy & Home Care
- Kennebec Pharmacy & Home Care, LLC
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Auburn | Other | Kennebec Pharmacy and Home Care LLC |
| Other URL | Augusta | Other | Kennebec Pharmacy and Home Care LLC |
National Provider Directory
National Provider Directory- Tax ID family
- Kennebec Pharmacy Home Car
- Part of
- Kennebec Pharmacy Home Car
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Oxygen Equipment & Supplies (DME)
- Brunswick, ME
- NPI 1063445625
-
- Parenteral & Enteral Nutrition Supplies (DME)
- Augusta, ME
- NPI 1487668927
-
dba Kennebec Pharmacy & Home Care
- Durable Medical Equipment & Medical Supplies
- Rockport, ME
- NPI 1710992342
Locations
12 Atlantic Pl
Unit 12A
South Portland, ME 04106
12 Atlantic Pl
Unit A12
South Portland, ME 04106
Phone (207) 626-2130
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607990400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1775001600000",
"number": "1962098848",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 ATLANTIC PL UNIT A-12",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041062316",
"telephone_number": "207-626-2130",
"fax_number": "207-502-8030"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENNEBEC PHARMACY AND HOME CARE, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KENNEBEC PHARMACY & HOME CARE, LLC",
"enumeration_date": "2020-12-15",
"last_updated": "2026-04-01",
"certification_date": "2026-04-01",
"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": "129010001",
"state": "ME"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Auburn",
"affiliation": "Y",
"endpointDescription": "mail",
"affiliationName": "Kennebec Pharmacy and Home Care LLC",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Auburn",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Augusta",
"address_1": "219 Mount Auburn Ave",
"city": "Auburn",
"state": "ME",
"country_code": "US",
"postal_code": "042108521",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Augusta",
"affiliation": "Y",
"endpointDescription": "phone",
"affiliationName": "Kennebec Pharmacy and Home Care LLC",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Augusta",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Augusta",
"address_1": "12 Atlantic Pl Unit 12-A",
"city": "South Portland",
"state": "ME",
"country_code": "US",
"postal_code": "041062316",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Kennebce Pharmacy & Home Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Kennebec Pharmacy & Home Care, LLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Kennebec Pharmacy & Home Care, LLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.