PENOBSCOT COMMUNITY HEALTH CENTER (NPI# 1013000942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013000942 |
| Entity Type | Organization |
| Organization Name | PENOBSCOT COMMUNITY HEALTH CENTER |
| Other Organization Name | BREWER HIGH SCHOOL BASED CLINIC |
| Practice Address |
79 Parkway S Brewer ME 04412 |
| Mailing Address |
Po Box 1599 103 Maine Ave Bangor ME 04402-1599 |
| Practice Telephone | 2079922456 |
| Practice Fax Number | 2079922154 |
| Mailing Telephone | 2079455247 |
| Mailing Fax Number | 2079922154 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-08-06 |
| Authorized Official Name | LORI L. DWYER (PRESIDENT & CEO) |
| Authorized Official Telephone | 2079929200 |
| Authorized Official Credential | ESQ. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Brewer High School Based Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760973960 | Penobscot Community Health Center | Clinic/Center | 1012 Union St Ste 3, Bangor, ME 04401-3058 | 2018-05-23 |
| 1134632870 | Penobscot Community Health Center | Community/Behavioral Health | 85 Hammond St, Bangor, ME 04401-4913 | 2017-11-15 |
| 1720535651 | Penobscot Community Health Center | Dentist | 100 Moosehead Blvd, Bangor, ME 04401 | 2016-09-08 |
| 1174845697 | Penobscot Community Health Center | Clinic/Center | 181 Corporate Drive, Bangor, ME 04401 | 2010-02-25 |
| 1831282771 | Penobscot Community Health Center | Family Medicine | 1048 Union St, Suite 5, Bangor, ME 04401-8600 | 2006-10-02 |
| 1922191857 | Penobscot Community Health Center | General Practice | 92 Pendleton St, Brewer, ME 04412 | 2006-10-02 |
| 1659464584 | Penobscot Community Health Center | Family Medicine | 992 Union St. Suite J, Bangor, ME 04402 | 2006-10-02 |
| 1083259410 | Penobscot Community Health Center | Family Medicine | 1068 Union St, Bangor, ME 04401-3016 | 2019-11-08 |
| 1366800138 | Penobscot Community Health Center | Clinic/Center | 376 Main St, Jackman, ME 04945-5214 | 2016-02-08 |
| 1275906893 | Penobscot Community Health Center | Podiatrist | 242 Brunswick St, Old Town, ME 04468 | 2015-11-04 |
| Street Address |
79 PARKWAY S |
| City | BREWER |
| State | ME |
| Zip Code | 04412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063719276 | Karen Doten | Specialist/Technologist | 79 Parkway S, Pupil Services Office, Brewer, ME 04412-1627 | 2011-02-24 |
| 1700183910 | Carie Cuskelly | Specialist/Technologist | 79 Parkway S, Pupil Services Office, Brewer, ME 04412-1627 | 2011-02-24 |
| 1801193016 | Rebecca P. Shultz | Occupational Therapist | 79 Parkway S, Pupil Services Office, Brewer, ME 04412-1627 | 2011-02-24 |
| 1679660161 | Emily Alice Barrington | Counselor | 79 Parkway S, Brewer, ME 04412-1627 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205326899 | Kolby Arnold | Physical Therapist | 277 State St., Brewer, ME 04412 | 2018-05-18 |
| 1215434477 | Kelley Anne Hill | Counselor | 17 Houston Lane, Brewer, ME 04412 | 2018-04-12 |
| 1497250740 | Northeast Dental Partners, Pa | Dentist | 24 Dirigo Drive, Brewer, ME 04412 | 2018-03-28 |
| 1821549445 | Jenelle Hazzard | Nurse Practitioner | 735 Wilson St., Brewer, ME 04412 | 2016-10-19 |
| 1154877520 | Gentle Hands Home Care | Home Health | 153 State St Suite 5, Brewer, ME 04412 | 2016-08-26 |
| 1932459708 | Danielle M Kissinger | Physical Medicine & Rehabilitation | 227 State St, Brewer, ME 04412 | 2012-09-19 |
| 1750658738 | Todd James Hachey | Pharmacist | 437 Wilson St., Walgreens 11545, Brewer, ME 04412 | 2011-11-19 |
| 1407154107 | Judy Anderson | Speech-Language Pathologist | 79 Parkway South, Pupil Services Office, Brewer, ME 04412 | 2011-03-03 |
| 1487898508 | Elizabeth A Morse | Technician/Technologist | 272 State Street, Optical Outlet, LLC, Brewer, ME 04412 | 2009-04-21 |
| 1396902359 | Mindy J Smith | Occupational Therapy Assistant | 74 Parkway South, Brewer, ME 04412 | 2008-05-19 |
| Find all providers in zip 04412 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922191857 | Penobscot Community Health Center | General Practice | 92 Pendleton St, Brewer, ME 04412 | 2006-10-02 |
| 1639130099 | Gary Michael Ross | General Practice | 401 S Main St, Brewer, ME 04412-2322 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942822978 | Sme New Hampshire P.C. | General Practice | 87 Libby Hill Rd, Newport, ME 04953-4147 | 2020-05-13 |
| 1700311693 | Jennifer Cornelius | General Practice | 32 Lobster Cove Rd, York, ME 03909-1269 | 2017-04-27 |
| 1013254499 | Deane Lawrence Hutchins | General Practice | 30 Community Dr Apt 165, Camden, ME 04843-2065 | 2013-01-06 |
| 1063656460 | Floyd B Goffin | General Practice | 23 Pennell Way, Brunswick, ME 04011-7915 | 2009-04-29 |
| 1447432919 | Robert P Doyle, M.d., P.a. | General Practice | 87 S High St, Bridgton, ME 04009-1123 | 2007-11-27 |
| 1124207162 | Jane Garfield Dba Mednow Clinic Ellsworth | General Practice | 5 Long Ln, Ellsworth, ME 04605-1734 | 2007-10-26 |
| 1285773903 | Robert P. Hayes | General Practice | 11 Bolduc Ave, Winslow, ME 04901-7108 | 2007-02-06 |
| 1326107228 | Joseph Thomas Field | General Practice | 4 Pier Rd, Cape Porpoise, ME 04014 | 2006-12-06 |
| 1679583678 | Richard Clarke Macdonald | General Practice | 3 Forest St, Dover-foxcroft, ME 04426 | 2006-08-09 |
| 1053338855 | Sally Haley | General Practice | 93 Church Rd, Brunswick, ME 04011-7306 | 2006-07-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.