Provider Demographics
NPI:1548344237
Name:LINCOLNHEALTH COVES EDGE
Entity type:Organization
Organization Name:LINCOLNHEALTH COVES EDGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-633-8423
Mailing Address - Street 1:40 BELVEDERE RD
Mailing Address - Street 2:
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543-4550
Mailing Address - Country:US
Mailing Address - Phone:207-563-4592
Mailing Address - Fax:207-563-8352
Practice Address - Street 1:40 BELVEDERE RD
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4550
Practice Address - Country:US
Practice Address - Phone:207-563-4592
Practice Address - Fax:207-563-8352
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCOLNHEALTH COVES EDGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-25
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36439251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME201505Medicare Oscar/Certification