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CH01458BF PENOBSCOT COMMUNITY HEALTH CENTER, INC (Terminated)
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Main Details
Name
PENOBSCOT COMMUNITY HEALTH CENTER, INC
Subdivision Name
Forest Hills Schools JCHC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013333
340B ID
CH01458BF
Grant Number
H80CS04291
Additional Details
Current Program Status
Terminated
Registration Date
4/7/2014
Participating Start Date
7/1/2014
Participating Approval Date
4/17/2014
Last Recertification Date
2/10/2021
Termination Date
Termination Reason
4/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Penobscot Community Health Center Inc.
Lorelle Dwyer, President & CEO
(207) 992-9200
Primary Contact
Penobscot Community Health Center Inc
Frank R McGrady, Executive Clinical Director of Pharmacy
(207) 992-9200 Ext: 1539
Addresses
Street Address
606 Main St
Jackman, ME 04945-5002
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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