Penobscot Community Health Center

NPI #1760973960 in Bangor, Maine

Provider Information

NPI Number: 1760973960
Entity Type: Organization
Organization Name: Penobscot Community Health Center
Subpart: Yes (part of a larger organization)
Parent Organization: PENOBSCOT COMMUNITY HEALTH CENTER
Primary Specialty: Clinic/Center - Infusion Therapy
Enumeration Date: May 23, 2018
Last Updated: May 23, 2018

Practice Location

Address: 1012 UNION ST STE 3
City: Bangor
State: Maine
ZIP Code: 04401-3058
Phone: (207) 404-8100

Authorized Official

Name: LORI L. DWYER, ESQ.
Title: PRESIDENT & CEO
Phone: (207) 992-9200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X
Clinic/Center - Infusion Therapy — Infusion Therapy	261QI0500X	Primary

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