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DSH200039AD MAINEGENERAL MEDICAL CENTER (Active)
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Main Details
Name
MAINEGENERAL MEDICAL CENTER
Subdivision Name
Diabetes & Nutrition Augusta
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200039AD
Medicare Provider Number
200039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/10/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/2/2013
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
Ballard Center
6 East Chestnut Street
Augusta, ME 04330
Billing Address
MaineGeneral Medical Center
Attn: Accounts Payable
35 Medical Center Parkway
Augusta, ME 04330
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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4/10/2014 - Multiple terminations/reinstatements recorded in error; site remained continuously eligible from participation start date.
04/14/2014
03/20/2014: Termination recorded in error; site remained continuously eligible from participation start date.
03/31/2014
April 2025
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