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CAH201312-21 WALDO COUNTY GENERAL HOSPITAL (Terminated)
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Main Details
Name
WALDO COUNTY GENERAL HOSPITAL
Subdivision Name
WCMP General Surgery
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH201312-21
Medicare Provider Number
201312
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/8/2017
Last Recertification Date
11/29/2017
Termination Date
Termination Reason
7/1/2018
Other
Contacts
Authorizing Official
Waldo County General Hospital
Linda Drinkwater, CFO
(207) 505-4104
Primary Contact
Waldo County General Hospital and Pen Bay Medical Center
Denise Needham, Regional Director of Pharmacy
(207) 921-8577
Addresses
Street Address
16 Fahy St, Suite 202
Cobb Medical Building
Belfast, ME 04915
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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