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CH01458BP PENOBSCOT COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
PENOBSCOT COMMUNITY HEALTH CENTER
Subdivision Name
Old Town High School RSU 34
Type
HRSA-Funded Health Center
Site ID
BPS-H80-037334
340B ID
CH01458BP
Grant Number
H80CS04291
Additional Details
Current Program Status
Active
Registration Date
1/16/2024
Participating Start Date
4/1/2024
Participating Approval Date
3/6/2024
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
203 Stillwater Ave
Old Town, ME 04468-1665
Billing Address
Penobscot Community Health Center, Inc
103 Maine Ave
Bangor, ME 04401
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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