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100 Campus Ave Ste 208 Lewiston ME 04240-6069 | |
(207) 777-8974 | |
(207) 777-8946 |
Full Name | |
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Speciality | Clinic/Center |
Location | 100 Campus Ave Ste 208, Lewiston, Maine |
Authorized Official Name and Position | Coleen L Elias (CEO/CFO) |
Authorized Official Contact | 2075133897 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 95000 Lbx 7660 Philadelphia PA 19195-0001 Ph: (207) 777-8202 | 100 Campus Ave Ste 208 Lewiston ME 04240-6069 Ph: (207) 777-8974 |
NPI Number | 1710279344 |
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Provider Enumeration Date | 05/16/2011 |
Last Update Date | 10/22/2020 |
Medicare PECOS PAC ID | 0042101099 |
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Medicare Enrollment ID | O20110715000039 |
Identifier | Type | State | Issuer |
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1710279344 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Community Clinical Services, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 57 Birch St Ste 102, Lewiston, ME 04240 Phone: 207-753-5400 Fax: 207-786-0489 | |
Central Maine Clinical Associates Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 364 Main Street, Lewiston, ME 04240 Phone: 207-795-5709 Fax: 207-795-7193 | |