| 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 |