| Penobscot Community Health Center | |
|
242 Brunswick St Old Town ME 04468 | |
| (207) 827-6128 | |
| (207) 827-5533 |
| Full Name | Penobscot Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 242 Brunswick St, Old Town, Maine |
| Authorized Official Name and Position | Lori L. Dwyer (PRESIDENT & CEO) |
| Authorized Official Contact | 2079929200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Penobscot Community Health Center Po Box 1599 Bangor ME 04402-1599 Ph: (207) 945-5247 | Penobscot Community Health Center 242 Brunswick St Old Town ME 04468 Ph: (207) 827-6128 |
| NPI Number | 1629161559 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 08/06/2018 |
| Medicare PECOS PAC ID | 0143212670 |
|---|---|
| Medicare Enrollment ID | O20091125000111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629161559 | NPI | - | NPPES |
| 131160200 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 201847 FQHC MEDICARE (Maine) | Primary |
Riversedge Chiropractic Wellness Center Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 227 Main St, Old Town, ME 04468 Phone: 207-827-5951 Fax: 720-368-0639 | |
Penobscot Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 242 Brunswick St, Old Town, ME 04468 Phone: 207-827-6128 | |
Penobscot Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 576 Stillwater Ave, Old Town, ME 04468 Phone: 207-404-8000 | |
Penobscot Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 Stillwater Ave, Old Town, ME 04468 Phone: 207-404-8000 | |
Riversedge Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 227 Main St, Old Town, ME 04468 Phone: 207-827-5951 | |
Penobscot Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 156 Oak St, Old Town, ME 04468 Phone: 207-404-8000 |