Provider Demographics
NPI:1487179669
Name:BOOTHBAY REGION HEALTH CARE INC
Entity type:Organization
Organization Name:BOOTHBAY REGION HEALTH CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEYBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-633-4368
Mailing Address - Street 1:185 TOWNSEND AVE STE R
Mailing Address - Street 2:
Mailing Address - City:BOOTHBAY HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04538-1895
Mailing Address - Country:US
Mailing Address - Phone:207-633-1075
Mailing Address - Fax:877-492-1491
Practice Address - Street 1:185 TOWNSEND AVE STE R
Practice Address - Street 2:
Practice Address - City:BOOTHBAY HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04538-1895
Practice Address - Country:US
Practice Address - Phone:207-633-1075
Practice Address - Fax:207-633-1067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty