BREWER COMMUNITY SCHOOL BASED CLINIC – NPI #1922191857
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

BREWER COMMUNITY SCHOOL BASED CLINIC is a provider located in BREWER, ME. NPPES has assigned the NPI number 1922191857 to BREWER COMMUNITY SCHOOL BASED CLINIC on October 02, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BREWER COMMUNITY SCHOOL BASED CLINIC” is a dba name, the actual legal business name for this organization is PENOBSCOT COMMUNITY HEALTH CENTER. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 8 years ago on Aug 06, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BREWER COMMUNITY SCHOOL BASED CLINIC below.

NPI Profile for
PENOBSCOT COMMUNITY HEALTH CENTER

NPI Number
1922191857
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PENOBSCOT COMMUNITY HEALTH CENTER
Doing Business As (dba): BREWER COMMUNITY SCHOOL BASED CLINIC
Primary location
92 PENDLETON ST
BREWER, ME 04412
Phone: (207) 992-2393 Fax: (207) 992-2154
Mailing address
PO BOX 1599
103 MAINE AVE
BANGOR, ME 04402-1599
Phone: (207) 945-5247 Fax: (207) 992-2154
Organization Subpart
No
Authorized Official
LORI DWYER
PRESIDENT & CEO
Phone: (207) 992-9200
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.