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DSH200039F MAINEGENERAL MEDICAL CENTER (Active)
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Main Details
Name
MAINEGENERAL MEDICAL CENTER
Subdivision Name
Augusta Family Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200039F
Medicare Provider Number
200039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2013
Participating Start Date
10/1/2016
Participating Approval Date
6/18/2013
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
MaineGeneral Medical Center
Terrance Brann, Chief Financial Officer
(207) 623-6624
Primary Contact
MaineGeneral Medical Center
Jennifer A Kent, 340B Coordinator
(207) 248-5160
Addresses
Street Address
15 Enterprise Drive
2nd Floor
Augusta, ME 04330
Billing Address
MaineGeneral Medical Center
Accounts Payable
35 Medical Center Parkway
Augusta, ME 04330
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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9/13/16 Participated starting 7/1/2013, terminated 4/1/2014, reinstated 10/1/2016.
09/13/2016
4/10/2014 - Multiple terminations/reinstatements recorded in error; site has remained ineligible since initial termination date.
04/02/2014
April 2025
April 2025
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