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DSH200033 EASTERN MAINE MEDICAL CENTER (Active)
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Main Details
Name
EASTERN MAINE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH200033
Medicare Provider Number
200033
Additional Details
Current Program Status
Active
Registration Date
5/8/2008
Participating Start Date
10/1/2003
Participating Approval Date
5/8/2008
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
Eastern Maine Medical Center
Randy Brian Albert, VP Finance
(207) 973-4279
Primary Contact
Eastern Maine Medical Center
Lynn Thornton, Director of Pharmacy
(207) 973-9012
Addresses
Street Address
489 STATE STREET
BANGOR, ME 04401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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