Organization Name: | PENOBSCOT COMMUNITY HEALTH CENTER |
NPI Number: | 1023458320 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH SCHMIDT (PRESIDENT & CEO) |
Mailing Address: | 53 Schoodic Dr Belfast |
State: | ME US |
Postal Code: | 049157246 |
Phone Number: | 2073386900 |
Fax Number: | |
NPI Enumeration Date: | 07/01/2013 |
NPI Last Update Date: | 01/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |