# BANGOR MEDICAL CENTER INC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134299068
- **Authorized official:** MRS. RENEE M MILLER (BILLING MANAGER)
- **Authorized official phone:** 61005887661

## Contact information

- **Practice address:** 153 N 11TH ST, BANGOR, PA 18013-1603
- **Practice address phone:** (610) 588-4502
- **Practice address fax:** (610) 588-6928
- **Mailing address:** 153 N ELEVENTH ST, BANGOR, PA 18013
- **Mailing address phone:** (610) 588-4502
- **Mailing address fax:** (610) 588-6928

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | PA | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 07/21/2022