| Healthreach Community Health Centers | |
|
25 Depot St Kingfield ME 04947-4208 | |
| (207) 265-4555 | |
| (207) 265-5004 |
| Full Name | Healthreach Community Health Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 25 Depot St, Kingfield, Maine |
| Authorized Official Name and Position | Constance R Coggins (PRESIDENT/CEO) |
| Authorized Official Contact | 2078725610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthreach Community Health Centers 25 Depot St Kingfield ME 04947-4208 Ph: (207) 265-4555 | Healthreach Community Health Centers 25 Depot St Kingfield ME 04947-4208 Ph: (207) 265-4555 |
| NPI Number | 1023082385 |
|---|---|
| Provider Enumeration Date | 02/14/2006 |
| Last Update Date | 11/10/2014 |
| Medicare PECOS PAC ID | 5496726523 |
|---|---|
| Medicare Enrollment ID | O20050830000534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023082385 | NPI | - | NPPES |
| 137970102 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | E58728 (Maine) | Primary |
| Provider Name | Lois C Hamel Corson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730135039 PECOS PAC ID: 4880650613 Enrollment ID: I20041203000464 |
| Provider Name | Cynthia R Robertson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316911787 PECOS PAC ID: 7012952278 Enrollment ID: I20050628000443 |
| Provider Name | Roy Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700854361 PECOS PAC ID: 9032306212 Enrollment ID: I20101214000796 |
| Provider Name | Catherine Ann Yu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669604112 PECOS PAC ID: 6406993914 Enrollment ID: I20140627001780 |
| Provider Name | Diane Zavotsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023128261 PECOS PAC ID: 8123099215 Enrollment ID: I20141104001286 |
| Provider Name | Angela Kristoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124570833 PECOS PAC ID: 3375825706 Enrollment ID: I20170120000081 |
| Provider Name | Kelly Bell Bragg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386121978 PECOS PAC ID: 6608126602 Enrollment ID: I20180913000200 |