340B Drug Pricing Program Database


DSH200033H EASTERN MAINE MEDICAL CENTER (Terminated) - information as of 5/2/2025 10:29:49 PM

Main Details
EASTERN MAINE MEDICAL CENTER
EMMC Orono Family Medicine
Disproportionate Share Hospital
No
DSH200033H
200033


Additional Details
Terminated
1/14/2013
4/1/2013
3/7/2013
9/2/2023

10/1/2024
Site closure

Contacts

Eastern Maine Medical Center
Randy Brian Albert, VP Finance
(207) 973-4279

Eastern Maine Medical Center
Lynn Thornton, Director of Pharmacy
(207) 973-9012

Addresses

84 Kelley Road
Orono, ME 04473

Eastern Maine Medical Center
489 State Street
Bangor, ME 04401


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
ME1017800001790789147
Shipping Addresses

Eastern Maine Medical Center
489 State Street
Bangor, ME 04401
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH200033AChildDSHEASTERN MAINE MEDICAL CENTERWalk-In-Care915 Union Street, Suite 4BangorMEActive
DSH200033AAChildDSHEASTERN MAINE MEDICAL CENTERNORTHEAST SURGERY OF MAINE417 State StBangorMEActive
DSH200033ABChildDSHEASTERN MAINE MEDICAL CENTERPEDIATRIC DERMATOLOGY OF MAINE133 Corporate DriveBANGORMEActive
DSH200033ACChildDSHEASTERN MAINE MEDICAL CENTERPEDIATRIC ORTHOPEDIC CENTER OF MAINE417 State StBANGORMEActive
DSH200033ADChildDSHEASTERN MAINE MEDICAL CENTERSURGERY & TRAUMA SPECIALISTS OF ME417 State StreetBANGORMEActive
DSH200033AEChildDSHEASTERN MAINE MEDICAL CENTERSURGERY&TRAUMA SPECIALISTS OF ME (Orthopedic SURGERY)417 State StBANGORMEActive
DSH200033AFChildDSHEASTERN MAINE MEDICAL CENTERWOMEN'S HEALTH CARE OF ME (MATERNAL/FETAL MED)417 State StBANGORMEActive
DSH200033AGChildDSHEASTERN MAINE MEDICAL CENTERWOMEN'S HEALTH CARE OF ME (OB/GYN)417 State StBANGORMEActive
DSH200033AHChildDSHEASTERN MAINE MEDICAL CENTEREMMC NORTHEAST CARDIOLOGY ASSOCIATES1 Northeast DriveBANGORMEActive
DSH200033AJChildDSHEASTERN MAINE MEDICAL CENTEREMMC UNIVERSITY MEDICINE, CUTLER HEALTH CENTER5721 Long RdOronoMEActive
DSH200033AKChildDSHEASTERN MAINE MEDICAL CENTERVASCULAR CARE OF MAINE489 STATE STBANGORMEActive
DSH200033ALChildDSHEASTERN MAINE MEDICAL CENTERINTERVENTIONAL PAIN MANAGEMENT CLINIC925 UNION STBANGORMEActive
DSH200033AMChildDSHEASTERN MAINE MEDICAL CENTEREMMC RHEUMATOLOGY & ANEMIA MANAGEMENT33 WHITING HILL RDBREWERMEActive
DSH200033ANChildDSHEASTERN MAINE MEDICAL CENTEREMMC PLASTIC AND HAND SURGERY417 STATE STBANGORMEActive
DSH200033APChildDSHEASTERN MAINE MEDICAL CENTEREMMC FAMILY MEDICINE7 MAIN N RDHAMPDENMEActive
DSH200033AQChildDSHEASTERN MAINE MEDICAL CENTEREMMC Hearing Center905 Union StBangorMEActive
DSH200033ARChildDSHEASTERN MAINE MEDICAL CENTERBEHAVORIAL MEDICINE84 Kelley RdORONOMEActive
DSH200033ASChildDSHEASTERN MAINE MEDICAL CENTERINFECTIOUS DISEASE PROFESSIONAL SER417 STATE STBANGORMEActive
DSH200033ATChildDSHEASTERN MAINE MEDICAL CENTERNEUROPSYCHOLOGY OF MAINE417 STATE STBANGORMEActive
DSH200033AUChildDSHEASTERN MAINE MEDICAL CENTERRAISH PEAVEY HASKELL PEDIATRIC ONCOLOGY33 WHITING HILL RDBREWERMEActive
DSH200033AVChildDSHEASTERN MAINE MEDICAL CENTERTHE WOW PROGRAM5721 Long RdORONOMETerminated
DSH200033AWChildDSHEASTERN MAINE MEDICAL CENTEREMMC BREAST SURGICAL SPECIALISTS33 WHITING HILL RDBREWERMEActive
DSH200033AXChildDSHEASTERN MAINE MEDICAL CENTEREMMC NEUROLOGY SPECIALISTS905 Union StreetBANGORMEActive
DSH200033AYChildDSHEASTERN MAINE MEDICAL CENTEREMMC ALLERGY AND IMMUNOLOGY SPECIAL885 UNION STBANGORMEActive
DSH200033AZChildDSHEASTERN MAINE MEDICAL CENTEREMMC PELVIC CARE AND CONTINENCE SPECIALISTS417 STATE STREETBANGORMETerminated
DSH200033BChildDSHEASTERN MAINE MEDICAL CENTERCancer Care of Maine33 Whiting Hill Rd, Suites 1 and 21BrewerMEActive
DSH200033BAChildDSHEASTERN MAINE MEDICAL CENTERNORTHEAST SURGERY OF MAINE - 2ND LOCATION404 STATE ST, STE 310BANGORMEActive
DSH200033BBChildDSHEASTERN MAINE MEDICAL CENTERNorthern Light Urology - Urology404 State StreetBangorMEApproved
DSH200033CChildDSHEASTERN MAINE MEDICAL CENTEREMMC Family Medicine Center and Residency895 Union Street, Suite 12BangorMEActive
DSH200033DChildDSHEASTERN MAINE MEDICAL CENTERDiabetes, Endocrine and Nutrition Center905 Union Street, Suite 11BangorMEActive
DSH200033EChildDSHEASTERN MAINE MEDICAL CENTERDiabetes Endocrine Specialists of Maine885 Union Street, Suite 235BangorMEActive
DSH200033FChildDSHEASTERN MAINE MEDICAL CENTEREastern Maine Otolaryngology885 Union Street, Suite 145BangorMEActive
DSH200033GChildDSHEASTERN MAINE MEDICAL CENTEREMMC Family Medicine of Brewer234 State StreetBrewerMEActive
DSH200033HChildDSHEASTERN MAINE MEDICAL CENTEREMMC Orono Family Medicine84 Kelley RoadOronoMETerminated
DSH200033JChildDSHEASTERN MAINE MEDICAL CENTEREMMC Family Medicine 302 Husson Avenue, Suite 2BangorMEActive
DSH200033KChildDSHEASTERN MAINE MEDICAL CENTEREMMC Internal Medicine302 Husson Avenue, Suite 1BangorMEActive
DSH200033LChildDSHEASTERN MAINE MEDICAL CENTEREMMC Pediatric Primary Care133 Corporate DriveBangorMEActive
DSH200033MChildDSHEASTERN MAINE MEDICAL CENTERMaine Rehab Outpatient Center84 Kelley RoadOronoMEActive
DSH200033NChildDSHEASTERN MAINE MEDICAL CENTEREMMC Orthopedic Surgical Specialists925 Union Street, Suite 3BangorMEActive
DSH200033PChildDSHEASTERN MAINE MEDICAL CENTERRetina Associates of Maine885 Union Street, Suite 130BangorMEActive
DSH200033QChildDSHEASTERN MAINE MEDICAL CENTERSurgical Endoscopy of Maine417 State StreetBangorMEActive
DSH200033RChildDSHEASTERN MAINE MEDICAL CENTERUrologic Surgery of Maine55 Broadway, Suite 2BangorMEActive
DSH200033SChildDSHEASTERN MAINE MEDICAL CENTERCARDIOTHORACIC SURGERY OF MAINE417 State StreetBANGORMEActive
DSH200033TChildDSHEASTERN MAINE MEDICAL CENTEREMMC NEUROSURGERY & SPINE SPECIALISTS417 State StBANGORMEActive
DSH200033UChildDSHEASTERN MAINE MEDICAL CENTEREMMC PEDIATRIC CARDIOLOGY417 State StBANGORMEActive
DSH200033VChildDSHEASTERN MAINE MEDICAL CENTERFOCUS EYE CARE OF MAINE885 Union StreetBANGORMEActive
DSH200033WChildDSHEASTERN MAINE MEDICAL CENTERGASTROENTEROLOGY CENTER OF MAINE417 State StBANGORMEActive
DSH200033XChildDSHEASTERN MAINE MEDICAL CENTERGYNECOLOGY ASSOCIATES OF MAINE417 State StBANGORMEActive
DSH200033YChildDSHEASTERN MAINE MEDICAL CENTEREMMC PEDIATRIC SPECIALTY CARE133 Corporate DriveBANGORMEActive
DSH200033ZChildDSHEASTERN MAINE MEDICAL CENTEREMMC PEDIATRIC Specialty Care (2nd location)417 State StBANGORMEActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsStateUpdate To Be TerminatedTerminated10/1/2024 12:01 AM
DatesLast Date That 340B Drugs PurchasedUpdateRecertification 12/30/2022 12:00:00 AM9/9/2024 5:07 PM
DetailsStateUpdateRecertificationActiveTo Be Terminated9/9/2024 5:07 PM
TerminationsTermination DateUpdateRecertification 10/1/2024 12:00:00 AM9/9/2024 5:07 PM
TerminationsTermination Effective DateUpdateRecertification 12/31/2022 12:00:00 AM9/9/2024 5:07 PM
TerminationsTermination ReasonUpdateRecertification Site closure9/9/2024 5:07 PM
ContactsAuthorizing OfficialUpdateAO Change RequestKelly, Maura VP Finance Northern Light EMMC 2075932991Albert, Randy Brian VP Finance Eastern Maine Medical Center 20797342799/3/2024 3:15 PM
DetailsLast Recertification DateUpdateRecertification9/9/2022 1:40:40 PM9/2/2023 4:23:46 PM9/2/2023 4:23 PM
ContactsAuthorizing OfficialUpdateAO Change RequestHanlon, Christopher R VP of Finance Eastern Maine Medical Center 2079736488Kelly, Maura VP Finance Northern Light EMMC 20759329918/30/2023 4:19 PM
ContactsAuthorizing OfficialUpdateAO Change RequestKenney, Stephen F SVP Finance Northern LIght Health 2079736488Hanlon, Christopher R VP of Finance Eastern Maine Medical Center 20797364881/27/2023 6:08 PM
ContactsPrimary ContactUpdateRecertificationCattin, James Director Pharmacy Services EMMC 2079738288Thornton, Lynn Director of Pharmacy Eastern Maine Medical Center 20797390129/9/2022 1:40 PM
DetailsLast Recertification DateUpdateRecertification8/30/2021 2:25:18 PM9/9/2022 1:40:40 PM9/9/2022 1:40 PM
ContactsAuthorizing OfficialUpdateAO Change RequestMorissette, Philippe SVP of Finance Eastern Maine Medical Center 2079736488Kenney, Stephen F SVP Finance Northern LIght Health 20797364889/6/2022 4:07 PM
DetailsLast Recertification DateUpdateRecertification9/8/2020 3:56:56 PM8/30/2021 2:25:18 PM8/30/2021 2:25 PM
Medicaid BillingNPI: StateUpdateRecertification ME9/8/2020 3:56 PM
DetailsLast Recertification DateUpdateRecertification8/28/2019 2:56:33 PM9/8/2020 3:56:56 PM9/8/2020 3:56 PM
DetailsLast Recertification DateUpdateRecertification8/28/2018 10:33:04 AM8/28/2019 2:56:33 PM8/28/2019 2:56 PM
ContactsAuthorizing OfficialUpdateChange RequestMcKinnon, Helen VP Support Services Eastern Maine Medical Center 2079737842Morissette, Philippe SVP of Finance Eastern Maine Medical Center 20797364889/28/2018 1:39 PM
DetailsLast Recertification DateUpdateRecertification11/13/2017 10:57:38 AM8/28/2018 10:33:04 AM8/28/2018 10:33 AM
DetailsLast Recertification DateUpdateRecertification8/18/2016 12:00:00 AM11/13/2017 10:57:38 AM11/13/2017 10:57 AM
ContactsPrimary ContactUpdateRecertificationCattin, James Director Pharmacy Services 2079738288Cattin, James Director Pharmacy Services EMMC 207973828811/13/2017 10:25 AM
ContactsAuthorizing OfficialUpdate McKinnon, Helen VP Support Services 2079737842McKinnon, Helen VP Support Services Eastern Maine Medical Center 207973784210/4/2017 1:44 PM
ContactsAuthorizing OfficialInsert  McKinnon, Helen VP Support Services 20797378426/30/2017 11:28 PM
ContactsPrimary ContactInsert  Cattin, James Director Pharmacy Services 20797382886/30/2017 11:28 PM
ContactsSigned ByInsert  Doucette, Elmer Vice President and CFO 20797364885/23/2017 2:04 PM
AddressesMain AddressInsert   84 Kelley Road Orono, ME 044735/23/2017 2:02 PM
AddressesBilling AddressInsert  Eastern Maine Medical Center 489 State Street Bangor, ME 044015/23/2017 2:02 PM
AddressesShipping AddressInsert  Eastern Maine Medical Center 489 State Street Bangor, ME 044015/23/2017 2:02 PM
Medicaid BillingMedicaid: NumberUpdate 01-02115011017800005/23/2017 2:02 PM
DetailsLast Recertification DateUpdate 8/27/2015 12:00:00 AM8/18/2016 12:00:00 AM8/18/2016 1:54 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False8/5/2016 3:11 PM
Medicaid BillingMedicaid: NumberInsert  01-02115018/5/2016 3:11 PM
Medicaid BillingMedicaid: StateInsert  ME8/5/2016 3:11 PM
DetailsLast Recertification DateUpdate 9/8/2014 12:00:00 AM8/27/2015 12:00:00 AM8/27/2015 8:39 AM
DetailsLast Recertification DateUpdate 9/11/2013 9:50:14 AM9/8/2014 12:00:00 AM9/8/2014 3:04 PM
DetailsLast Recertification DateUpdate  9/11/2013 9:50:14 AM9/11/2013 9:50 AM
Details340B IDUpdate ISBLDSH200033HDSH200033H3/7/2013 4:06 PM
DatesParticipating Approval DateUpdate  3/7/2013 12:00:00 AM3/7/2013 4:06 PM
DetailsStateUpdate PendingActive3/7/2013 4:06 PM
DatesStart DateUpdate  4/1/2013 12:00:00 AM3/7/2013 4:06 PM
Details340B IDUpdate OUTPATIENT_ONLINE_REGISBLDSH200033H3/4/2013 4:12 PM
Medicaid BillingNPI: NumberInsert  17907891471/14/2013 5:42 PM
DetailsLast Recertification DateInsert   1/14/2013 5:42 PM
DetailsGrant NumberInsert   1/14/2013 5:42 PM
Details340B IDInsert  OUTPATIENT_ONLINE_REG1/14/2013 5:42 PM
DetailsIs Authorizing Official EHB DataInsert   1/14/2013 5:42 PM
DatesLast Date That 340B Drugs PurchasedInsert   1/14/2013 5:42 PM
DetailsMedicare Provider NumberInsert  2000331/14/2013 5:42 PM
DetailsEntity NameInsert  EASTERN MAINE MEDICAL CENTER1/14/2013 5:42 PM
DetailsProgram CodeInsert  DSH1/14/2013 5:42 PM
DetailsEntity SubnameInsert  EMMC Orono Family Medicine1/14/2013 5:42 PM
DatesParticipating Approval DateInsert   1/14/2013 5:42 PM
DetailsStateInsert  Pending1/14/2013 5:42 PM
DatesRegistration DateInsert  1/14/2013 12:00:00 AM1/14/2013 5:42 PM
DatesSigned By DateInsert  1/14/2013 12:00:00 AM1/14/2013 5:42 PM
DatesStart DateInsert   1/14/2013 5:42 PM
TerminationsTermination CommentsInsert   1/14/2013 5:42 PM
TerminationsTermination DateInsert   1/14/2013 5:42 PM
TerminationsTermination Effective DateInsert   1/14/2013 5:42 PM
TerminationsTermination ReasonInsert   1/14/2013 5:42 PM