Provider Demographics
NPI:1356740997
Name:SOUTHERN MAINE HEARING, INC
Entity type:Organization
Organization Name:SOUTHERN MAINE HEARING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:HOLLY
Authorized Official - Last Name:THIBODEAU
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:207-233-1167
Mailing Address - Street 1:251 US ROUTE 1 STE 9
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1322
Mailing Address - Country:US
Mailing Address - Phone:207-781-7200
Mailing Address - Fax:207-781-7203
Practice Address - Street 1:251 US ROUTE 1 STE 9
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1322
Practice Address - Country:US
Practice Address - Phone:207-781-7200
Practice Address - Fax:207-781-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP2234237600000X
237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty