| Fish River Rural Health | |
|
10 Carter St. Eagle Lake ME 04739-0309 | |
| (207) 444-5973 | |
| (207) 444-5520 |
| Full Name | Fish River Rural Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 10 Carter St., Eagle Lake, Maine |
| Authorized Official Name and Position | Heather Pelletier (CEO) |
| Authorized Official Contact | 2074445973 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fish River Rural Health 10 Carter St. Po Box 309 Eagle Lake ME 04739-0309 Ph: (207) 444-5973 | Fish River Rural Health 10 Carter St. Eagle Lake ME 04739-0309 Ph: (207) 444-5973 |
| NPI Number | 1376761288 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 11/15/2016 |
| Medicare PECOS PAC ID | 3577531953 |
|---|---|
| Medicare Enrollment ID | O20101104000714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376761288 | NPI | - | NPPES |
| 121330001 | Medicaid | ME | |
| 005514 | Other | ME | ANTHEM BLUE CROSS SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |