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CH01458BS PENOBSCOT COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
PENOBSCOT COMMUNITY HEALTH CENTER
Subdivision Name
Bangor School Dept. SBHC William S Cohen Middle School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-038662
340B ID
CH01458BS
Grant Number
H80CS04291
Additional Details
Current Program Status
Active
Registration Date
10/11/2024
Participating Start Date
1/1/2025
Participating Approval Date
12/4/2024
Last Recertification Date
3/7/2025
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
304 Garland St
Bangor, ME 04401
Billing Address
PENOBSCOT COMMUNITY HEALTH CENTER, INC.
103 Main Ave
BANGOR, ME 04402-2100
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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