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CAH201317-00 NORTHERN MAINE MEDICAL CENTER (Active)
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Main Details
Name
NORTHERN MAINE MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH201317-00
Medicare Provider Number
201317
Additional Details
Current Program Status
Active
Registration Date
12/4/2024
Participating Start Date
12/6/2024
Participating Approval Date
12/6/2024
Last Recertification Date
Contacts
Authorizing Official
Northern Maine Medical Center
Alain Bois, Chief Operating Officer
(207) 834-1411
Primary Contact
Northern Maine Medical Center
Jordan Albert, Director of Pharmacy
(207) 834-1632
Addresses
Street Address
194 EAST MAIN STREET
FORT KENT, ME 04743
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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