Organization · Type 2 NPI

Penobscot Community Health Center

Federally Qualified Health Center (FQHC) · Jackman, ME

NPI number 1669802849 Active

Practice location

376 Main St
Jackman, ME 04945

Call (207) 668-4300 Map

Fax (207) 668-7605

Mailing address

PO Box 1599
Bangor, ME 04402-1599

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

8 other providers at this address

NPI record

NPI: 1669802849
Entity type: Organization (Type 2)
Issued: Nov 25, 2013
Last updated: Aug 6, 2018
Status: Active
Subpart: Yes of Penobscot Community Health Center

Other names

<unavail>
Jackman Community Health Center · doing business as

Authorized official

Lori L. Dwyer, ESQ.
President & CEO
(207) 992-9200

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1669802849

Penobscot Community Health Center's National Provider Identifier is 1669802849, issued on Nov 25, 2013. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Jackman, ME. The record was last updated on Aug 6, 2018.