Provider Demographics
NPI:1730159617
Name:BEDARD MEDICAL INC
Entity type:Organization
Organization Name:BEDARD MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NADEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-440-2223
Mailing Address - Street 1:359 MINOT AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-4329
Mailing Address - Country:US
Mailing Address - Phone:207-784-3700
Mailing Address - Fax:207-784-7992
Practice Address - Street 1:359 MINOT AVE STE A
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-3303
Practice Address - Country:US
Practice Address - Phone:207-784-3700
Practice Address - Fax:207-784-7992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1056216332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME4068000001Medicare NSC