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CAH201301-08 CHARLES A. DEAN MEMORIAL HOSPITAL (Approved)
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Main Details
Name
CHARLES A. DEAN MEMORIAL HOSPITAL
Subdivision Name
NORTHERN LIGHT INTEGRATED BEHAVIORAL HEALTH - SANGERVILLE - BEHAVIORAL HEALTH
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH201301-08
Medicare Provider Number
201301
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/15/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/21/2025
Last Recertification Date
Contacts
Authorizing Official
CA Dean
JENNIFER GOODRICH, CFO
(207) 695-5209
Primary Contact
Northern Light CA Dean and Mayo Hospitals
Deidre Gilbert, Regional Director of Pharmacy
(207) 695-5270
Addresses
Street Address
22 HALEY COURT
SANGERVILLE, ME 04479
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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