Organization
PENOBSCOT COMMUNITY HEALTH CENTER
Active
Parent organization
PENOBSCOT COMMUNITY HEALTH CENTER
Other names
Warren Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENOBSCOT COMMUNITY HEALTH CENTER
Authorized official
LORI L. DWYER ESQ. (PRESIDENT & CEO)
(207) 992-9200
Entity
Organization
Contact information
Practice address
6 TELCOM DR, BANGOR, ME 04401-3072
(207) 941-2850
(207) 941-2852
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 941-2850
(207) 941-2852
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
ME
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103380000
—
ME
Enumeration date
05/12/2006
Last updated
01/27/2020
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