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CAH201312-08 MAINEHEALTH WALDO HOSPITAL (Active)
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Main Details
Name
MAINEHEALTH WALDO HOSPITAL
Subdivision Name
WCMP Primary & Walk-In Care
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH201312-08
Medicare Provider Number
201312
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/7/2014
Last Recertification Date
8/24/2024
Contacts
Authorizing Official
Coastal Healthcare Alliance
Heather Shanklin, Chief Financial Officer
(207) 505-4131
Primary Contact
Coastal Health Alliance, MaineHealth
David MacMillan, Pharmacy Director
(207) 301-8563
Addresses
Street Address
119 Northport Avenue
First Floor, Biscone Building
Belfast, ME 04915
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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