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DSH200033AM EASTERN MAINE MEDICAL CENTER (Active)
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Main Details
Name
EASTERN MAINE MEDICAL CENTER
Subdivision Name
EMMC RHEUMATOLOGY & ANEMIA MANAGEMENT
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH200033AM
Medicare Provider Number
200033
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/16/2016
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
Eastern Maine Medical Center
Randy Brian Albert, VP Finance
(207) 973-4279
Primary Contact
Eastern Maine Medical Center
Lynn Thornton, Director of Pharmacy
(207) 973-9012
Addresses
Street Address
33 WHITING HILL RD
Suite 34
BREWER, ME 04412-1022
Billing Address
Eastern Maine Medical Center
489 State St.
Bangor, ME 04401
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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