Organization
PENOBSCOT COMMUNITY HEALTH CENTER
Active
Parent organization
PENOBSCOT COMMUNITY HEALTH CENTER
Other names
Brewer Medical 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
735 WILSON ST, BREWER, ME 04412
(207) 989-1567
(207) 989-6889
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 945-5247
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131160100
—
ME
05
—
131160200
—
ME
Enumeration date
01/09/2008
Last updated
08/06/2018
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