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CAH201301-02 CHARLES A. DEAN MEMORIAL HOSPITAL (Active)
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Main Details
Name
CHARLES A. DEAN MEMORIAL HOSPITAL
Subdivision Name
NORTHWOODS HEALTHCARE
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH201301-02
Medicare Provider Number
201301
Outpatient Facility Provider Number
203987
Additional Details
Current Program Status
Active
Registration Date
12/6/2010
Participating Start Date
1/1/2011
Participating Approval Date
12/7/2010
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
CA Dean
JENNIFER GOODRICH, CFO
(207) 695-5209
Primary Contact
Northern Light CA Dean and Mayo Hospitals
Deidre Gilbert, Regional Director of Pharmacy
(207) 695-5270
Addresses
Street Address
364 PRITHAM AVE
GREENVILLE, ME 04441
Billing Address
CHARLES A. DEAN MEMORIAL HOSPITAL
43 WHITING HILL RD
BREWER, ME 04412
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/6/12- Updated entity name (was CHARLES A. DEAN MEMORIAL HOSPITAL AND NURSING HOME)
03/06/2012
April 2025
April 2025
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