Organization
PENOBSCOT COMMUNITY HEALTH CENTER
Active
Parent organization
PENOBSCOT COMMUNITY HEALTH CENTER
Other names
PCHC Infusion 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
1012 UNION ST STE 3, BANGOR, ME 04401-3058
(207) 404-8100
(207) 947-0435
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 404-8200
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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