340B Drug Pricing Program Database
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DSH200039BC MAINEGENERAL MEDICAL CENTER (Active)
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Main Details
Name
MAINEGENERAL MEDICAL CENTER
Subdivision Name
Thayer Center for Health / Ultrasound - Thayer
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200039BC
Medicare Provider Number
200039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/28/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/26/2014
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
MaineGeneral Medical Center
Terrance Brann, Chief Financial Officer
(207) 623-6624
Primary Contact
MaineGeneral Medical Center
Jennifer A Kent, 340B Coordinator
(207) 248-5160
Addresses
Street Address
Thayer Center for Health
149 North Street
Waterville, ME 04901
Billing Address
MaineGeneral Medical Center
Accounts Payable
35 Medical Center Parkway
Augusta, ME 04330
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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