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HM04101 MAINE MEDICAL CENTER (Active)
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Main Details
Name
MAINE MEDICAL CENTER
Subdivision Name
MAINE HEMOPHILIA AND THROMBOSIS CENTER
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM04101
Grant Number
H30MC24048
Additional Details
Current Program Status
Active
Registration Date
2/21/2008
Participating Start Date
4/1/2008
Participating Approval Date
2/21/2008
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
MaineHealth
Chris Coon, Southern Region Vice President, Finance
(207) 662-6213
Primary Contact
MaineHealth
Louise Baca, Senior Director
(207) 396-7504
Addresses
Street Address
22 BRAMHALL ST
PORTLAND, ME 04101
Billing Address
Maine Medical Center /MAINE HEMOPHILIA AND THROMBOSIS CENTER
100 CAMPUS DRIVE
103
SCARBOROUGH, ME 04074-9308
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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3/29/11 ADDED NPI
02/21/2008
April 2025
April 2025
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