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DSH200024AJ CENTRAL MAINE MEDICAL CENTER (Active)
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Main Details
Name
CENTRAL MAINE MEDICAL CENTER
Subdivision Name
Central Maine Pulmonology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200024AJ
Medicare Provider Number
200024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/25/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/26/2022
Last Recertification Date
8/25/2024
Contacts
Authorizing Official
Central Maine Healthcare
Steve Littleson, Interim President & CEO
(207) 795-2947
Primary Contact
Central Maine Healthcare
Marcia Gooden, 340B Program Manager
(207) 795-2325
Addresses
Street Address
76 HIGH STREET
300
Lewiston, ME 04240
Billing Address
Central Maine Healthcare
29 Lowell Street
Attn: Pamela Cook
STE 3
Lewiston, ME 04240
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (4/1/2014) until terminated effective date: (1/1/2016), reinstatement effective date: (4/1/2022)
01/26/2022
June 2025
June 2025
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