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CH01458BH PENOBSCOT COMMUNITY HEALTH CENTER (Terminated)
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Main Details
Name
PENOBSCOT COMMUNITY HEALTH CENTER
Subdivision Name
United Cerebral Palsy of Northeastern Maine
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005207
340B ID
CH01458BH
Grant Number
H80CS04291
Additional Details
Current Program Status
Terminated
Registration Date
10/3/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/7/2016
Last Recertification Date
2/10/2022
Termination Date
Termination Reason
4/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Penobscot Community Health Center Inc.
Lorelle Dwyer, President & CEO
(207) 992-9200
Primary Contact
Penobscot Community Health Center Inc
Frank R McGrady, Executive Clinical Director of Pharmacy
(207) 992-9200 Ext: 1539
Addresses
Street Address
700 Mount Hope Ave STE 320
Bangor, ME 04401-5680
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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