Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 735 Wilson St, Brewer, Maine |
Authorized Official Name and Position | Lori L. Dwyer (PRESIDENT & CEO) |
Authorized Official Contact | 2079929200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 1599 Bangor ME 04402-1599 Ph: (207) 945-5247 | 735 Wilson St Brewer ME 04412 Ph: (207) 989-1567 |
NPI Number | 1841475712 |
---|---|
Provider Enumeration Date | 01/09/2008 |
Last Update Date | 08/06/2018 |
Medicare PECOS PAC ID | 0143212670 |
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Medicare Enrollment ID | O20090213000522 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841475712 | NPI | - | NPPES |
131160200 | Medicaid | ME | |
131160100 | Medicaid | ME |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Maine) | Primary |
Brewer Health Center Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 S Main St, Brewer, ME 04412 Phone: 207-989-5588 Fax: 207-989-1599 | |