340B Drug Pricing Program Database
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DSH200018Y THE AROOSTOOK MEDICAL CENTER (Active)
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Main Details
Name
THE AROOSTOOK MEDICAL CENTER
Subdivision Name
TAMC EAR, NOSE & THROAT SERVICES
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH200018Y
Medicare Provider Number
200018
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/11/2017
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
The Aroostook Medical Center
Samuel Jacob Dobson, VP of Finance
(207) 768-4268
Primary Contact
Northern Light AR Gould Hospital
Kayla H Bates, Director of Pharmacy
(207) 768-4808
Addresses
Street Address
140 ACADEMY ST
PRESQUE ISLE, ME 04769-3102
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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