| Penobscot Community Health Center | |
|
775 N Main St Winterport ME 04496 | |
| (207) 945-5247 | |
| Not Available |
| Full Name | Penobscot Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 775 N Main St, Winterport, 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 775 N Main St Winterport ME 04496 Ph: (207) 945-5247 |
| NPI Number | 1093136871 |
|---|---|
| Provider Enumeration Date | 12/23/2013 |
| Last Update Date | 08/06/2018 |
| Medicare PECOS PAC ID | 0143212670 |
|---|---|
| Medicare Enrollment ID | O20140122001926 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093136871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Sunbury Primary Care, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 775 N Main Rd, Winterport, ME 04496 Phone: 207-223-5074 Fax: 207-223-5953 |