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BRISTOL HOSPICE - BANGOR, LLC
NPI 1336916469
Hospice Care, Community Based in Bangor, ME

Active since December 08, 2023CLIA 20D2306044 · Waiver
824 STILLWATER AVE STE B, BANGOR, ME 04401(207) 605-9620(207) 531-3438 Get Directions Write a Review

NPPES record last updated: July 1, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 1, 2024, Jun 27, 2024, Dec 8, 2023 (3 updates tracked since 2023).

About Bristol Hospice - Bangor, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRISTOL HOSPICE - BANGOR, LLC (NPI 1336916469) is a healthcare organization registered as a hospice care, community based in Bangor, Maine and active in the NPI registry since December 2023. The organization holds a CLIA Waiver certificate valid through June 10, 2028 and lists Alex Mauricio, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1336916469
Entity TypeOrganization
Primary Taxonomy251G00000X
Legal Business NameBRISTOL HOSPICE - BANGOR, LLC
Location Address824 STILLWATER AVE STE BBangor, ME 04401-3614
Mailing Address206 N 2100 W Ste 202Salt Lake City, UT 84116-4741 · (801) 325-0175
Phone(207) 605-9620
Fax(207) 531-3438
Organization SubpartNo
Authorized OfficialAlex MauricioPresident/ceo · (801) 325-0175
Enumeration DateDecember 8, 2023
Last NPPES UpdateJuly 1, 20243 updates tracked since enumeration
NPPES CertifiedJuly 1, 2024
✔ NPI 1336916469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospice Care, Community BasedAgencies
Taxonomy Code251G00000X
824 STILLWATER AVE STE B, Bangor, ME 04401
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D2306044

Bristol Hospice - Bangor, LLC · Bangor, ME
Active · expires Jun 10, 2028
CLIA Number20D2306044
Laboratory TypeHospice
Certificate Effective DateJune 11, 2026
Certificate Expiration DateJune 10, 2028
Laboratory DirectorErica Lilly
Laboratory Phone(207) 605-9620
Laboratory LocationBristol Hospice - Bangor, LLC824 Stillwater Ave Ste B, Bangor, ME 04401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bristol Hospice - Bangor, LLC's NPI number?

The NPI number for Bristol Hospice - Bangor, LLC is 1336916469. It was assigned to this organization in the NPPES registry on December 8, 2023.

Where is Bristol Hospice - Bangor, LLC located?

Bristol Hospice - Bangor, LLC is located at 824 Stillwater Ave Ste B, Bangor, ME 04401. The listed phone number is (207) 605-9620.

What is Bristol Hospice - Bangor, LLC's specialty?

The primary specialty registered for this NPI is Hospice Care, Community Based with taxonomy code 251G00000X.

Does Bristol Hospice - Bangor, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D2306044) is associated with this NPI, valid through June 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bristol Hospice - Bangor, LLC was last updated on July 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.