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CHC25680-05 PORTLAND COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
PORTLAND COMMUNITY HEALTH CENTER
Subdivision Name
Greater Portland Health at Casco Bay High School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018696
340B ID
CHC25680-05
Grant Number
H80CS25680
Additional Details
Current Program Status
Active
Registration Date
10/26/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/14/2016
Last Recertification Date
2/28/2025
Contacts
Authorizing Official
Portland Community Health Center
Ann Tucker, Chief Executive Officer
(207) 874-2141 Ext: 3886
Primary Contact
Portland Community Health Center
Tara Leblanc, Director of HR & Financial Reporting
(207) 874-2141
Addresses
Street Address
196 ALLEN AVE
PORTLAND, ME 04103-3711
Billing Address
Greater Portland Health
180 Park Avenue
Portland, ME 04102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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