BLACK BEAR MEDICAL, INC. (NPI# 1417425117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417425117 |
| Entity Type | Organization |
| Organization Name | BLACK BEAR MEDICAL, INC. |
| Practice Address |
1113 Stillwater Ave Bangor ME 04401-2617 |
| Mailing Address |
1019 Town Dr Highland Heights KY 41076-9114 |
| Practice Telephone | 2079899849 |
| Practice Fax Number | 2079890462 |
| Mailing Telephone | 8594418876 |
| Mailing Fax Number | 8594415850 |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2018-11-12 |
| Authorized Official Name | GREG CRAWFORD (CEO) |
| Authorized Official Telephone | 8594418876 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 128710000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538165642 | Black Bear Medical, Inc. | Durable Medical Equipment & Medical Supplies | 275 Marginal Way, Portland, ME 04101-2542 | 2005-06-23 |
| Street Address |
1113 STILLWATER AVE |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-2617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912475609 | Coastal Med-tech Corp. | Durable Medical Equipment & Medical Supplies | 1113 Stillwater Ave, Bangor, ME 04401-2617 | 2018-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790960854 | Lcm Enterprises | Durable Medical Equipment & Medical Supplies | 1008 Stillwater Ave, Bangor, ME 04401-5023 | 2008-01-08 |
| 1679638712 | Mac-lin Inc | Durable Medical Equipment & Medical Supplies | 173 Park St, Bangor, ME 04401-5023 | 2006-12-27 |
| 1275904435 | John W. Clark Pa | Durable Medical Equipment & Medical Supplies | 753 Stillwater Ave, Bangor, ME 04401-3633 | 2015-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366696627 | Northern Prosthetics | Durable Medical Equipment & Medical Supplies | 117 Academy Street, Presque Isle, ME 04769-3000 | 2008-11-12 |
| 1205028073 | Nbs LLC | Durable Medical Equipment & Medical Supplies | 3 Eastview Pkwy Ste 1, Saco, ME 04072-6701 | 2007-08-15 |
| 1295806388 | Rite Aid of Maine Inc | Durable Medical Equipment & Medical Supplies | 16 Peck Farm Road, Winthrop, ME 04364-1565 | 2006-11-13 |
| 1649280637 | Pediatric Physical Therapy Connection | Durable Medical Equipment & Medical Supplies | 170 Us Route One, Suite 180, Falmouth, ME 04105 | 2006-08-09 |
| 1447283213 | Medi-rents of Maine, Inc. | Durable Medical Equipment & Medical Supplies | 1037 R Forest Avenue, Portland, ME 04103-3339 | 2006-07-07 |
| 1558306498 | Mms Southern Maine, Inc. | Durable Medical Equipment & Medical Supplies | 49 Topsham Fair Mall Rd, Ste 7, Topsham, ME 04086-1734 | 2006-06-17 |
| 1245210558 | Acadia Home Care | Durable Medical Equipment & Medical Supplies | 470 Riverside St, Unit 10, Portland, ME 04103-5908 | 2006-01-20 |
| 1982684700 | Acadia Home Care | Durable Medical Equipment & Medical Supplies | 108 Main St, Suite 2, Presque Isle, ME 04769-2871 | 2006-01-18 |
| 1346220159 | Acadia Home Care | Durable Medical Equipment & Medical Supplies | 124 Freedom Pkwy, Hermon, ME 04401-1106 | 2006-01-18 |
| 1538165642 | Black Bear Medical, Inc. | Durable Medical Equipment & Medical Supplies | 275 Marginal Way, Portland, ME 04101-2542 | 2005-06-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.