| Penobscot Community Health Center | |
|
376 Main St Jackman ME 04945 | |
| (207) 668-4300 | |
| (207) 668-7605 |
| Full Name | Penobscot Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 376 Main St, Jackman, 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 376 Main St Jackman ME 04945 Ph: (207) 668-4300 |
| NPI Number | 1669802849 |
|---|---|
| Provider Enumeration Date | 11/25/2013 |
| Last Update Date | 08/06/2018 |
| Medicare PECOS PAC ID | 0143212670 |
|---|---|
| Medicare Enrollment ID | O20131227000601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669802849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Penobscot Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 376 Main St, Jackman, ME 04945 Phone: 207-668-7755 |