| Indian Township Tribal Government | |
|
401 Peter Dana Point Road Princeton ME 04668-0097 | |
| (207) 796-2321 | |
| (207) 796-2422 |
| Full Name | Indian Township Tribal Government |
|---|---|
| Speciality | Clinic/Center |
| Location | 401 Peter Dana Point Road, Princeton, Maine |
| Authorized Official Name and Position | Andrea M Hanson (COMPLIANCE SPECIALIST) |
| Authorized Official Contact | 2077962321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian Township Tribal Government Po Box 97 401 Peter Dana Point Rd Princeton ME 04668-0097 Ph: (207) 796-2321 | Indian Township Tribal Government 401 Peter Dana Point Road Princeton ME 04668-0097 Ph: (207) 796-2321 |
| NPI Number | 1205952140 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 09/28/2020 |
| Medicare PECOS PAC ID | 6103914445 |
|---|---|
| Medicare Enrollment ID | O20101109000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205952140 | NPI | - | NPPES |
| 107940000 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Maine) | Primary |