Organization
PENOBSCOT COMMUNITY HEALTH CENTER
Active
Parent organization
PENOBSCOT COMMUNITY HEALTH CENTER
Other names
Helen Hunt Health 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
242 BRUNSWICK ST, OLD TOWN, ME 04468
(207) 827-6128
(207) 827-5533
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 945-5247
(207) 992-2154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
201847 FQHC MEDICARE
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131160200
—
ME
Enumeration date
10/02/2006
Last updated
08/06/2018
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