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DSH200018 THE AROOSTOOK MEDICAL CENTER (Active)
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Main Details
Name
THE AROOSTOOK MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH200018
Medicare Provider Number
200018
Additional Details
Current Program Status
Active
Registration Date
4/14/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/12/2016
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
The Aroostook Medical Center
Samuel Jacob Dobson, VP of Finance
(207) 768-4268
Primary Contact
Northern Light AR Gould Hospital
Kayla H Bates, Director of Pharmacy
(207) 768-4808
Addresses
Street Address
140 ACADEMY STREET
PRESQUE ISLE, ME 04769
Billing Address
AROOSTOOK MEDICAL CENTER
140 Academy Street
PRESQUE ISLE, ME 04769
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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5/12/16 participating 10/1/10 until terminated 4/1/16, reinstated effective 7/1/16
05/12/2016
April 2025
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