Organization
PENOBSCOT COMMUNITY HEALTH CENTER
Active
Other names
Brewer Medical Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LORI DWYER ESQ. (PRESIDENT & CEO)
(207) 992-9200
Entity
Organization
Contact information
Practice address
735 WILSON STREET, BREWER, ME 04412
(207) 945-5247
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH50001392
ME
3336C0003X
Community/Retail Pharmacy
Primary
PH50001392
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008527
NCPDP
—
Enumeration date
05/12/2010
Last updated
08/06/2018
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