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CAH201312-23 MAINEHEALTH WALDO HOSPITAL (Active)
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Main Details
Name
MAINEHEALTH WALDO HOSPITAL
Subdivision Name
WCMP Surgical Associates
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH201312-23
Medicare Provider Number
201312
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/8/2017
Last Recertification Date
8/24/2024
Contacts
Authorizing Official
Coastal Healthcare Alliance
Heather Shanklin, Chief Financial Officer
(207) 505-4131
Primary Contact
Coastal Health Alliance, MaineHealth
David MacMillan, Pharmacy Director
(207) 301-8563
Addresses
Street Address
16 Fahy St, Suite 202
Cobb Medical Building, First Floor
Belfast, ME 04915
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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