Covered Entity Details

DSH200037 FRANKLIN MEMORIAL HOSPITAL (Terminated)

Main Details

Name

FRANKLIN MEMORIAL HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH200037

Medicare Provider Number

200037

Additional Details

Current Program Status

Terminated

Registration Date

9/19/2005

Participating Start Date

10/1/2016

Participating Approval Date

1/26/2007

Last Recertification Date

Termination Date
Termination Reason

4/1/2017
DSH percentage below statutory minimum

Contacts

Authorizing Official

Stephens Memorial Hospital
John W. Cox, Regional Chief Financial Officer
(207) 744-6024

Primary Contact

Franklin Memorial Hospital
Garry J. Miller, Director of Pharmacy
(207) 779-2426

Addresses

Street Address

111 FRANKLIN HEALTH COMMONS
FARMINGTON, ME 04938

Billing Address
Same as Street Address

Comment	Last Updated On
1 Item 1 to 3 of 3 Page: of 1 Page size:

1 Item 1 to 3 of 3 Page: of 1 Page size:
9/9/16 Participated as a DSH starting 4/1/2007, converted to a SCH on 1/1/2014. Converted back to DSH on 10/1/2016.	09/09/2016
11/30/07- DSH ADJ % >11.75 REINSTATED 4/1/07 - PREVIOUSLY PARTICIPATED FROM 9/19/05 THROUGH 12/31/05, INELIGIBLE FROM 1/1/06 THROUGH 3/31/07, DSH ADJUSTMENT % IS > 11.75%	12/03/2007
11/30/07- DSH ADJ % >11.75 REINSTATED 4/1/07 - PREVIOUSLY PARTICIPATED FROM 9/19/05 THROUGH 12/31/05, INELIGIBLE FROM 1/1/06 THROUGH 3/31/07, DSH ADJUSTMENT % IS > 11.75%	12/03/2007

340B Drug Pricing Program Database