Organization
PENOBSCOT COMMUNITY HEALTH CENTER
Active
Other names
Jackman Urgent Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
LORI L. DWYER ESQ. (PRESIDENT & CEO)
(207) 992-9200
Entity
Organization
Contact information
Practice address
376 MAIN ST, JACKMAN, ME 04945-5214
(207) 668-7755
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/08/2016
Last updated
02/22/2018
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