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CH01458AZ Penobscot Community Health Center (Active)
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Main Details
Name
Penobscot Community Health Center
Subdivision Name
992 Admin
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032269
340B ID
CH01458AZ
Grant Number
H80CS04291
Additional Details
Current Program Status
Active
Registration Date
7/2/2021
Participating Start Date
10/1/2021
Participating Approval Date
7/6/2021
Last Recertification Date
3/6/2025
Contacts
Authorizing Official
Penobscot Community Health Center Inc.
Lorelle Dwyer, President & CEO
(207) 992-9200
Primary Contact
Penobscot Community Health Care
Meagan Rusby, Associate Director of Pharmacy
(207) 992-9200 Ext: 1764
Addresses
Street Address
992 Union St Ste 3
Bangor, ME 04401-3057
Billing Address
Penobscot Community Health Center
103 Maine Ave
Bangor, ME 04401
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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