PENOBSCOT COMMUNITY HEALTH CENTER NPI 1093136871

NPI Information

NPI: 1093136871
Provider Name: PENOBSCOT COMMUNITY HEALTH CENTER

Doing Business As: WINTERPORT COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 20D2047543

Address:
775 N MAIN ST
WINTERPORT, ME
ZIP 04496
Phone: (207) 945-5247
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PENOBSCOT COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Winterport, ME. PENOBSCOT COMMUNITY HEALTH CENTER NPI is 1093136871. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Winterport Community Health Center.

The provider's business location address is:

775 N MAIN ST
WINTERPORT, ME
ZIP 04496
Phone: (207) 945-5247

The provider's authorized official is Lori L. Dwyer .
The authorized official title is President & Ceo and has the following contact phone number (207) 992-9200.

The CLIA number assigned to this NPI record is 20D2047543 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/23/2013 and was last updated on 8/6/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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