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CH01458BG PENOBSCOT COMMUNITY HEALTH CENTER, INC (Active)
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Main Details
Name
PENOBSCOT COMMUNITY HEALTH CENTER, INC
Subdivision Name
Seaport Community Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-033764
340B ID
CH01458BG
Grant Number
H80CS04291
Additional Details
Current Program Status
Active
Registration Date
8/6/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/15/2014
Last Recertification Date
3/6/2025
Contacts
Authorizing Official
Penobscot Community Health Center Inc.
Lorelle Dwyer, President & CEO
(207) 992-9200
Primary Contact
Penobscot Community Health Care
Meagan Rusby, Associate Director of Pharmacy
(207) 992-9200 Ext: 1764
Addresses
Street Address
29 Schoodic Dr
Belfast, ME 04915-7246
Billing Address
PENOBSCOT COMMUNITY HEALTH CENTER, INC
103 Maine Ave
BANGOR, ME 04401
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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