| Bridge Clinic | |
|
992 Union St Ste 3 Bangor ME 04401-3057 | |
| (207) 404-8330 | |
| (207) 947-0435 |
| Full Name | Bridge Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 992 Union St Ste 3, Bangor, Maine |
| Authorized Official Name and Position | Lorelle Dwyer (PRESIDENT & CEO) |
| Authorized Official Contact | 2079929200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge Clinic Po Box 1599 Bangor ME 04402-1599 Ph: (207) 404-8200 | Bridge Clinic 992 Union St Ste 3 Bangor ME 04401-3057 Ph: (207) 404-8330 |
| NPI Number | 1588868814 |
|---|---|
| Provider Enumeration Date | 06/12/2007 |
| Last Update Date | 11/13/2020 |
| Certification Date | 11/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588868814 | NPI | - | NPPES |
| 131160200 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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