| Penobscot Nation Health Department | |
|
23 Wabanaki Way Indian Island ME 04468-1252 | |
| (207) 817-7404 | |
| (207) 817-7459 |
| Full Name | Penobscot Nation Health Department |
|---|---|
| Speciality | Clinic/Center |
| Location | 23 Wabanaki Way, Indian Island, Maine |
| Authorized Official Name and Position | Nicole A Hines (ASSISTANT DIRECTOR) |
| Authorized Official Contact | 2078177404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Penobscot Nation Health Department 23 Wabanaki Way Indian Island ME 04468-1252 Ph: (207) 817-7404 | Penobscot Nation Health Department 23 Wabanaki Way Indian Island ME 04468-1252 Ph: (207) 817-7404 |
| NPI Number | 1639139140 |
|---|---|
| Provider Enumeration Date | 03/27/2006 |
| Last Update Date | 12/02/2013 |
| Medicare PECOS PAC ID | 1850324542 |
|---|---|
| Medicare Enrollment ID | O20100929001619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639139140 | NPI | - | NPPES |
| 106520100 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 201818 (Maine) | Primary |
Penobscot Nation Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 23 Wabanaki Way, Indian Island, ME 04468 Phone: 207-817-7400 Fax: 207-817-7459 |