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DSH200050M MAINE COAST MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
MAINE COAST MEMORIAL HOSPITAL
Subdivision Name
MAINE COAST REGIONAL HEALTH FACILITY / Family Practice
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200050M
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
45 HERRICK RD
SOUTHWEST HARBOR MEDICAL CENTER
SOUTHWEST HARBOR, ME 04679-4433
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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