Organization
PENOBSCOT COMMUNITY HEALTH CENTER
Active
Organization
PENOBSCOT COMMUNITY HEALTH CENTER
Active
Other names
Adult Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
LORELLE DWYER (CEO)
(207) 992-9200
Entity
Organization
Contact information
Practice address
1068 UNION ST, BANGOR, ME 04401-3016
(207) 404-8200
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 404-8200
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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