Organization
PENQUIS C.A.P., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES R NEWTON (EXECUTIVE DIRECTOR)
(207) 973-3500
Entity
Organization
Contact information
Practice address
262 HARLOW ST, BANGOR, ME 04401-4952
(207) 973-3500
(207) 973-3699
Mailing address
262 HARLOW ST, BANGOR, ME 04401-4952
(207) 973-3500
(207) 973-3699
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137980202
MAINECARE
ME
Enumeration date
05/04/2009
Last updated
05/04/2009
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