PORTLAND MAINE MH ORC (1025)    INSTITUTION (4)

Name Value
NAME PORTLAND MAINE MH ORC
STATE MAINE
STREET ADDR. 1 141 W COMMERCIAL ST
CITY PORTLAND
ZIP 04102-9998
OFFICIAL VA NAME PORTLAND MAINE MH ORC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME PORTLAND VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1114961992
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 402HC
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1114961992
  • CODING SYSTEM:   VASTANUM
    ID:   402HC