PENOBSCOT COMMUNITY HEALTH CENTER


Address: 376 Main St, Jackman, ME 04945-5214
Phone: 2076687755

PENOBSCOT COMMUNITY HEALTH CENTER (NPI# 1366800138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366800138
Entity Type Organization
Organization Name PENOBSCOT COMMUNITY HEALTH CENTER
Other Organization Name JACKMAN URGENT CARE CENTER
Practice Address 376 Main St
Jackman
ME 04945-5214
Mailing Address Po Box 1599
Bangor
ME 04402-1599
Practice Telephone 2076687755
Enumeration Date 2016-02-08
Last Update Date 2018-02-22
Authorized Official Name LORI L. DWYER (PRESIDENT & CEO)
Authorized Official Telephone 2079929200
Authorized Official Credential ESQ.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities
N 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities
Y 261QU0200X Clinic/Center
Specialization: Urgent Care
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Jackman Urgent Care Center Doing Business As Name - Organization

Other Provider IDs and Locations

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
1013000942 Penobscot Community Health Center General Practice 79 Parkway S, Brewer, ME 04412 2006-10-02
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
1275906893 Penobscot Community Health Center Podiatrist 242 Brunswick St, Old Town, ME 04468 2015-11-04

Office Location

Street Address 376 MAIN ST
City JACKMAN
State ME
Zip Code 04945-5214

Providers in the same location

NPI Name Taxonomy Address Enumeration
1407375777 Town of Jackman Ambulance 376 Main St, Jackman, ME 04945-9999 2017-09-18
1821458506 Julia B St John Social Worker 376 Main St, Jackman, ME 04945 2016-02-24
1679950463 Nancy German Social Worker 376 Main St, Jackman, ME 04945-5214 2015-04-30
1669802849 Penobscot Community Health Center Clinic/Center 376 Main St, Jackman, ME 04945 2013-11-25
1104908300 Mainegeneral Medical Center Nursing Facility/Intermediate Care Facility 376 Main St, Jackman, ME 04945-5214 2006-10-19
1295787448 Douglas M Morong Physician Assistant 376 Main St, Jackman, ME 04945-5214 2006-05-16
1255389987 Anna Babiarz Physician Assistant 376 Main St, Jackman, ME 04945-5214 2006-05-05
1801851654 Patricia S Doyle Family Medicine 376 Main St, Jackman, ME 04945-5214 2006-04-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225454531 Penobscot Community Health Center Dental Hygienist 606 Main St, Jackman, ME 04945 2014-03-11
1487876678 Maine School Administrative District #12 Local Education Agency (LEA) 606 Main Street, Jackman, ME 04945-0239 2007-05-03
1003123688 Theresa M. Crawford Specialist/Technologist 606 Main St, Jackman, ME 04945-5002 2010-09-03
1871653949 North Country Associates, Inc Intermediate Care Facility, Mentally Retarded 382 Main St, Jackman, ME 04945-5214 2006-12-11

Taxonomy Information

Taxonomy Code 261QU0200X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Urgent Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1154988707 Maine Urgent Care, LLC Clinic/Center 685 Sabattus Street, Lewiston, ME 04240-0000 2019-05-20
1093276370 Convenientmd LLC Clinic/Center 193 Bath Road, Brunswick, ME 04011 2019-03-28
1700355567 Careall P.C. Clinic/Center 230 Waterman Dr, South Portland, ME 04106-3635 2018-11-21
1992281422 Convenientmd LLC Clinic/Center 543 Broadway, Bangor, ME 04401-3337 2018-07-18
1821589029 York Hospital Clinic/Center 2 Independence Dr Ste B, Kennebunk, ME 04043-6078 2018-05-23
1548617780 Occuaptional Health Centers of The Southwest, P.a. Clinic/Center 54 Rumery, Industrial Park, Portland, ME 04106 2016-05-18
1982051488 Occuaptional Health Centers of The Southwest, P.a. Clinic/Center 1 Idexx Dr, Westbrook, ME 04092-2040 2016-05-16
1578918132 Occuaptional Health Centers of The Southwest, P.a. Clinic/Center 113 Wells St, North Berwick, ME 03906-6751 2016-05-02
1437504198 Occuaptional Health Centers of The Southwest, P.a. Clinic/Center 205 Spencer Dr, Wells, ME 04090-5553 2016-05-02
1366897027 Occuaptional Health Centers of The Southwest, P.a. Clinic/Center 89 Cumberland St, Westbrook, ME 04092-3592 2016-05-02
Find all providers with the same taxonomy

Competitor

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City JACKMAN
Zip Code 04945

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Dataset Information

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.

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