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DSH200039DU MAINEGENERAL MEDICAL CENTER (Approved)
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Main Details
Name
MAINEGENERAL MEDICAL CENTER
Subdivision Name
MaineGeneral College Health - College Health
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200039DU
Medicare Provider Number
200039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/14/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/22/2025
Last Recertification Date
Contacts
Authorizing Official
MaineGeneral Medical Center
Terrance Brann, Chief Financial Officer
(207) 623-6624
Primary Contact
MaineGeneral Medical Center
Jennifer A Kent, 340B Coordinator
(207) 248-5160
Addresses
Street Address
Thayer Center for Health
149 North Street
Waterville, ME 04901
Billing Address
MaineGeneral Medical Center
35 Medical Center Parkway
Attn: Accounts Payable
Augusta, ME 04330
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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