340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH200063Q PENOBSCOT BAY MEDICAL CENTER (Active)
Print
Main Details
Name
PENOBSCOT BAY MEDICAL CENTER
Subdivision Name
Dr. Robert Laurence MD Internal Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200063Q
Medicare Provider Number
200063
Outpatient Facility Provider Number
200063
Additional Details
Current Program Status
Active
Registration Date
7/5/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/11/2013
Last Recertification Date
8/24/2024
Contacts
Authorizing Official
Coastal Healthcare Alliance
Heather Shanklin, Chief Financial Officer
(207) 505-4131
Primary Contact
Coastal Health Alliance, MaineHealth
David MacMillan, Pharmacy Director
(207) 301-8563
Addresses
Street Address
760 Commercial Street
Rockport, ME 04856
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session