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DSH200009EG MAINEHEALTH MAINE MEDICAL CENTER (Approved)
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Main Details
Name
MAINEHEALTH MAINE MEDICAL CENTER
Subdivision Name
MaineHealth Maine Medical Center Sanford Post Anesthesia Care Unit - Post Anesthesia Care Unit
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH200009EG
Medicare Provider Number
200009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/8/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/16/2025
Last Recertification Date
Contacts
Authorizing Official
MaineHealth
Chris Coon, Southern Region Vice President, Finance
(207) 662-6213
Primary Contact
MaineHealth
BRIAN MARDEN, Chief Pharmacy Officer
(207) 661-3057
Addresses
Street Address
25 June St
Sanford, ME 04073
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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