PENOBSCOT COMMUNITY HEALTH CENTER (NPI# 1841475712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841475712 |
| Entity Type | Organization |
| Organization Name | PENOBSCOT COMMUNITY HEALTH CENTER |
| Other Organization Name | BREWER MEDICAL CENTER |
| Practice Address |
735 Wilson St Brewer ME 04412 |
| Mailing Address |
Po Box 1599 Bangor ME 04402-1599 |
| Practice Telephone | 2079891567 |
| Practice Fax Number | 2079896889 |
| Mailing Telephone | 2079455247 |
| Mailing Fax Number | 2079470435 |
| Enumeration Date | 2008-01-09 |
| 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 | Y |
| Parent Organization Name | PENOBSCOT COMMUNITY HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
ME | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 131160100 | 05 | |
| ME | 131160200 | 05 |
| Other Name | Type Code |
|---|---|
| Brewer Medical Center | 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 |
| 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 |
| 1366800138 | Penobscot Community Health Center | Clinic/Center | 376 Main St, Jackman, ME 04945-5214 | 2016-02-08 |
| Street Address |
735 WILSON ST |
| City | BREWER |
| State | ME |
| Zip Code | 04412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629074075 | Jennifer L Harvey | Physician Assistant | 735 Wilson St, Brewer, ME 04412 | 2005-06-21 |
| 1063067650 | Brooke Ann Morin | Nurse Practitioner | 735 Wilson St, Brewer, ME 04412-1000 | 2019-08-09 |
| 1043878648 | Cameron Goller | Nurse Practitioner | 735 Wilson St, Brewer, ME 04412-1000 | 2019-05-30 |
| 1700440104 | William J Bronson | Physician Assistant | 735 Wilson St, Brewer, ME 04412-1000 | 2019-05-01 |
| 1396204707 | Emily T. Thermos | Nurse Practitioner | 735 Wilson St, Brewer, ME 04412-1000 | 2019-03-15 |
| 1073077053 | David Wade Iv | Physician Assistant | 735 Wilson St, Brewer, ME 04412-1000 | 2019-01-24 |
| 1548733090 | Ellen Taraschi | Nurse Practitioner | 735 Wilson St, Brewer, ME 04412-1000 | 2019-01-08 |
| 1831680149 | Tiffany A. Albert | Counselor | 735 Wilson St, Brewer, ME 04412-1000 | 2018-05-22 |
| 1013404789 | Maegan L. Woodman | Nurse Practitioner | 735 Wilson St, Brewer, ME 04412 | 2018-04-18 |
| 1891297255 | Christine Bell | Physician Assistant | 735 Wilson St, Brewer, ME 04412-1000 | 2018-03-01 |
| Find all providers in the same location | ||||
| 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 | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538485214 | Penobscot Community Health Center | Clinic/Center | 735 Wilson Street, Brewer, ME 04412 | 2010-04-20 |
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| 1023621273 | Sebasticook Family Doctors | Clinic/Center | 291 Williams Road, Newport, ME 04953 | 2020-08-27 |
| 1295386316 | Community Clinical Services, Inc | Clinic/Center | 1250 Turner St, Auburn, ME 04210-6436 | 2019-09-20 |
| 1679047872 | Portland Community Health Center | Clinic/Center | 52 Frederic St, Portland, ME 04102-2700 | 2019-01-22 |
| 1043783822 | Portland Community Health Center | Clinic/Center | 72 Bishop St, Portland, ME 04102-2957 | 2019-01-04 |
| 1770056558 | Portland Community Health Center | Clinic/Center | 190 Valley Street, Portland, ME 04102-2957 | 2019-01-04 |
| 1760973960 | Penobscot Community Health Center | Clinic/Center | 1012 Union St Ste 3, Bangor, ME 04401-3058 | 2018-05-23 |
| 1700317971 | Portland Community Health Center | Clinic/Center | 28 Portland St, Portland, ME 04101-2912 | 2017-03-21 |
| 1184165367 | Katahdin Valley Health Center | Clinic/Center | 65 South St, Houlton, ME 04730-1550 | 2017-03-20 |
| 1255872537 | Portland Community Health Center | Clinic/Center | 175 Auburn St, Portland, ME 04103-2131 | 2017-03-20 |
| 1881135192 | Portland Community Health Center | Clinic/Center | 353 Cumberland Avenue, Cliff Island, ME 04109-0008 | 2017-03-20 |
| 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.