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CAH201303-00 PENOBSCOT VALLEY HOSPITAL (Active)
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Main Details
Name
PENOBSCOT VALLEY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH201303-00
Medicare Provider Number
201303
Additional Details
Current Program Status
Active
Registration Date
1/11/2011
Participating Start Date
4/1/2011
Participating Approval Date
2/23/2011
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Penobscot Valley Hospital
Melissa Pelkey, CEO
(207) 794-7127
Primary Contact
Penobscot Valley Hospital
Kristen L LaFreniere, Director of Pharmacy
(207) 794-7148
Addresses
Street Address
7 TRANSALPINE ROAD
LINCOLN, ME 04457
Billing Address
PENOBSCOT VALLEY HOSPITAL
PO BOX 368
LINCOLN, ME 04457
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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