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DSH200024D CENTRAL MAINE MEDICAL CENTER (Terminated)
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Main Details
Name
CENTRAL MAINE MEDICAL CENTER
Subdivision Name
Central Maine Pain and Headache Center - Wiscasset
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200024D
Medicare Provider Number
200024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/10/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/27/2014
Last Recertification Date
8/27/2014
Termination Date
Termination Reason
7/1/2015
Site closure
Contacts
Authorizing Official
Central Maine Healthcare Corporation
Philippe Morissette, VP of Finance
(207) 795-2972
Primary Contact
Central Maine Healthcare
Sean Cheetham, Taxation Manager
(207) 795-7533
Addresses
Street Address
721 Bath Road
Wiscasset, ME 04578
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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