Organization Name: | PENOBSCOT COMMUNITY HEALTH CENTER |
NPI Number: | 1427169010 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEN SCHMIDT (CEO AND PRESIDENT) |
Mailing Address: | 1012 Union St Bangor |
State: | ME US |
Postal Code: | 044013060 |
Phone Number: | 2079455247 |
Fax Number: | 2079077079 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 12/07/2012 |
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: |