NPIMap

Organization Active NPI

Penobscot Community Health Center

Doing business as PCHC Walk In - Bangor

  • Urgent Care Clinic/Center
  • Bangor, ME
National Provider Identifier
1639419468
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PENOBSCOT COMMUNITY HEALTH CENTER
Doing business as
PCHC Walk In - Bangor
Practice address
1012 Union St
Suite 3
Bangor, ME 04401-3060
Phone
(207) 945-5247
Fax
(207) 990-1248
NPI assigned
Feb 14, 2013
Last updated
Feb 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lori L. Dwyer, ESQ.
Title
President & Ceo
Phone
(207) 992-9200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Multi-Specialty Clinic/Center 261QM1300X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1012 Union St
Suite 3
Bangor, ME 04401-3060

Mailing address

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

Other names 1

  • PCHC Walk In - Bangor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Manna Inc40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

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

View all 39

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519257600000",
    "number": "1639419468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-945-5247",
            "fax_number": "207-907-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 UNION ST",
            "address_2": "SUITE 3",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013060",
            "telephone_number": "207-945-5247",
            "fax_number": "207-990-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENOBSCOT COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-14",
        "last_updated": "2018-02-22",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "207-992-9200",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCHC Walk In - Bangor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.