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Penobscot Community Health Center

Organization Active NPI General Practice Physician · Old Town, ME

NPI 1316711468 · NPPES record last updated Nov 9, 2023

Key facts

NPI
1316711468
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
PENOBSCOT COMMUNITY HEALTH CENTER
Practice address
576 Stillwater Ave
Old Town, ME 04468-2131
Phone
(207) 404-8000
NPI assigned
Nov 9, 2023
Organization subpart
No

Authorized official

Name
Lorelle Dwyer, ESQ
Title
President & Ceo
Phone
(207) 992-9200

Corporate family (same tax ID) 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Penobscot Community Health Care (40 organizations share this tax ID)

Locations

885 Broadway
Bangor, ME 04401
Phone (207) 992-5500

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208D00000X Yes

Addresses

Primary practice location

576 Stillwater Ave
Old Town, ME 04468-2131

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 945-5247

Other names

  • Old Town Elementary School RSU 34 Doing business as

Other providers in Old Town, ME

All providers in Old Town, ME · General Practice Physician in Maine

Sources for this page

Verify at the official NPI Registry.