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DSH200050F MAINE COAST MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
MAINE COAST MEMORIAL HOSPITAL
Subdivision Name
MAINE COAST REGIONAL HEALTH FACILITY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200050F
Medicare Provider Number
200050
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/12/2015
Last Recertification Date
8/30/2016
Termination Date
Termination Reason
4/1/2017
DSH percentage below statutory minimum
Contacts
Authorizing Official
Chris D. Frauenhofer, Chief Financial Officer
(207) 664-5308
Primary Contact
Chris D. Frauenhofer, Chief Financial Officer
(207) 664-5308
Addresses
Street Address
50 UNION STREET STE 1100
MAINE COAST OTOLARYNGOLOGY HEAD & NECK SURGERY
ELLSWORTH, ME 04605-1599
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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