| Passamaquoddy Tribal Council | |
|
11 Back Rd Pleasant Point ME 04667-4119 | |
| (207) 853-0644 | |
| (207) 853-2347 |
| Full Name | Passamaquoddy Tribal Council |
|---|---|
| Speciality | Clinic/Center |
| Location | 11 Back Rd, Pleasant Point, Maine |
| Authorized Official Name and Position | Crystal Bore (ADMIN ASSISTANT) |
| Authorized Official Contact | 2078530555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Passamaquoddy Tribal Council Po Box 351 Perry ME 04667-0351 Ph: (207) 853-0644 | Passamaquoddy Tribal Council 11 Back Rd Pleasant Point ME 04667-4119 Ph: (207) 853-0644 |
| NPI Number | 1760474613 |
|---|---|
| Provider Enumeration Date | 08/17/2005 |
| Last Update Date | 04/18/2024 |
| Medicare PECOS PAC ID | 0244252831 |
|---|---|
| Medicare Enrollment ID | O20090306000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760474613 | NPI | - | NPPES |
| 107300000 | Medicaid | ME | |
| 107300100 | Medicaid | ME | |
| 107300200 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Maine) | Primary |