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DSH200039CS MAINEGENERAL MEDICAL CENTER (Active)
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Main Details
Name
MAINEGENERAL MEDICAL CENTER
Subdivision Name
MaineGeneral / Ear, Nose and Throat
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200039CS
Medicare Provider Number
200039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2025
Participating Start Date
4/1/2025
Participating Approval Date
3/7/2025
Last Recertification Date
Contacts
Authorizing Official
MaineGeneral Medical Center
Terrance Brann, Chief Financial Officer
(207) 623-6624
Primary Contact
MaineGeneral Medical Center
Jennifer A Kent, 340B Coordinator
(207) 248-5160
Addresses
Street Address
Harold Alfond Center for Cancer Care
361 Old Belgrade Road
Augusta, ME 04330
Billing Address
MaineGeneral Medical Center
Accounts Payable
35 Medical Center Parkway
Augusta, ME 04330
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2016, terminated 10/1/2021. Reinstated 4/1/2025.
01/29/2025
April 2025
April 2025
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