Organization
PORTLAND COMMUNITY HEALTH CENTER
Active
Other names
Sagamore Village
Organization subpart
No
Provider details
NPI number
Authorized official
ANN F TUCKER (CEO)
(207) 874-2141
Entity
Organization
Contact information
Practice address
68 POPHAM ST, PORTLAND, ME 04102-1151
(207) 874-2141
(207) 874-2164
Mailing address
180 PARK AVE STE 1, PORTLAND, ME 04102-2927
(207) 874-2141
(207) 874-2164
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/27/2021
Last updated
07/03/2023
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