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DSH200024 CENTRAL MAINE MEDICAL CENTER (Active)
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Main Details
Name
CENTRAL MAINE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200024
Medicare Provider Number
200024
Additional Details
Current Program Status
Active
Registration Date
1/14/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/25/2022
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Central Maine Healthcare
Steve Littleson, Interim President & CEO
(207) 795-2947
Primary Contact
Central Maine Healthcare
Marcia Gooden, 340B Program Manager
(207) 795-2325
Addresses
Street Address
300 MAIN STREET
LEWISTON, ME 04240-4500
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (1/1/2010) until terminated effective date: (1/1/2016), reinstatement effective date (4/1/2022) 1/1/2016
01/25/2022
12/15/09 DOC. RECD. TO CONFIRM DSH ADJ. %; ORIG PART 10/1/04 - 6/30/09; NOT ELIG 7/1/09 -12/31/09; 5/14/08 REVISED MEDICAID # (WAS 010211494)
01/21/2010
May 2025
May 2025
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