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DSH200024AM CENTRAL MAINE MEDICAL CENTER (Terminated)
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Main Details
Name
CENTRAL MAINE MEDICAL CENTER
Subdivision Name
High Street Family Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200024AM
Medicare Provider Number
200024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/6/2015
Last Recertification Date
8/6/2015
Termination Date
Termination Reason
1/1/2016
DSH percentage below statutory minimum
Contacts
Authorizing Official
Central Maine Healthcare Corporation
Philippe Morissette, VP of Finance
(207) 795-2972
Primary Contact
Central Maine Healthcare Corporation
Philippe Morissette, VP of Finance
(207) 795-2972
Addresses
Street Address
10 High Street
Suite 301
Lewiston, ME 04240
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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