Full Name | |
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Speciality | Clinic/Center |
Location | 21 Winn Rd, Lee, Maine |
Authorized Official Name and Position | Nicole Morrison (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2077946700 |
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 99 Lincoln ME 04457-0099 Ph: (207) 794-6700 | 21 Winn Rd Lee ME 04455 Ph: (207) 794-6700 |
NPI Number | 1568701324 |
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Provider Enumeration Date | 02/13/2013 |
Last Update Date | 08/03/2018 |
Medicare PECOS PAC ID | 2769393180 |
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Medicare Enrollment ID | O20150810000193 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568701324 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |