Basic Information
| Provider Information | |||||||||
| NPI: | 1760485304 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARKVIEW ADVENTIST MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 329 MAINE ST | ||||||||
| Address2: | |||||||||
| City: | BRUNSWICK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040113310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2073732000 | ||||||||
| FaxNumber: | 2077210258 | ||||||||
| Practice Location | |||||||||
| Address1: | 329 MAINE ST | ||||||||
| Address2: | |||||||||
| City: | BRUNSWICK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040113310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2073732000 | ||||||||
| FaxNumber: | 2077210258 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2005 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | GANNON | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 2073732295 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 36117 | ME | Y | Hospitals | General Acute Care Hospital |
No ID Information.