PENOBSCOT NATION HEALTH DEPARTMENT
NPI 1639139140
Clinic/Center - Rural Health in Indian Island, ME

Q: What is Penobscot Indian Nation Finance Office's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since March 27, 2006CLIA 20D0719653 · Microscopy

23 WABANAKI WAY, INDIAN ISLAND, ME 04468(207) 817-7404(207) 817-7459 Get Directions Write a Review

NPPES record last updated: December 2, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Penobscot Nation Health Department NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENOBSCOT NATION HEALTH DEPARTMENT (NPI 1639139140) is a healthcare organization registered as a rural health in Indian Island, Maine and active in the NPI registry since March 2006. The organization holds a CLIA Microscopy certificate valid through October 15, 2026 and lists Nicole A Hines, Assistant Director, as its authorized official.

NPPES Registry Identity

NPI1639139140

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NamePENOBSCOT INDIAN NATION FINANCE OFFICE

Location Address23 WABANAKI WAYIndian Island, ME 04468-1252

Mailing Address23 Wabanaki WayIndian Island, ME 04468-1252 · (207) 817-7404 · Fax (207) 817-7459

Phone(207) 817-7404

Fax(207) 817-7459

Organization SubpartYes

Authorized OfficialNicole A HinesAssistant Director · (207) 817-7404

Enumeration DateMarch 27, 2006

Last NPPES UpdateDecember 2, 2013

✔ NPI 1639139140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

License✔ Licensed in ME · 201818

23 WABANAKI WAY, Indian Island, ME 04468

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Other Names 1

Doing Business AsPenobscot Nation Health Department

Other Identifiers 2

Medicaid106520100ME

Medicare ID-Type Unspecified20-1818Id Number

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 20D0719653

Penobscot Nation Health Dept · Indian Island, ME

Active · expires Oct 15, 2026

CLIA Number20D0719653

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateOctober 16, 2024

Certificate Expiration DateOctober 15, 2026

Laboratory DirectorBenjamin W. Huerth MD

Laboratory Phone(207) 827-6101

Laboratory LocationPenobscot Nation Health Dept23 Wabanaki Way, Indian Island, ME 04468

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. WINONA ALICE NICOLAR

Pharmacy Technician