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CH01458AA PENOBSCOT COMMUNITY HEALTH CENTER, INC. (Terminated)
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Main Details
Name
PENOBSCOT COMMUNITY HEALTH CENTER, INC.
Subdivision Name
JLH BOARDING HOUSE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-006789
340B ID
CH01458AA
Grant Number
H80CS04291
Additional Details
Current Program Status
Terminated
Registration Date
11/30/2006
Participating Start Date
1/1/2007
Participating Approval Date
12/4/2006
Last Recertification Date
2/15/2018
Termination Date
Termination Reason
1/1/2019
Other
Contacts
Authorizing Official
Penobscot Community Health Center Inc.
Lorelle Dwyer, President & CEO
(207) 992-9200
Primary Contact
Penobscot Community Health Center Inc
Frank R McGrady, Executive Clinical Director of Pharmacy
(207) 992-9200 Ext: 1539
Addresses
Street Address
87 OHIO STREET
BANGOR, ME 04401
Billing Address
PENOBSCOT COMMUNITY HEALTH CENTER, INC.
PO BOX 2100
BANGOR, ME 04402-2100
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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