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SCH200050-00 MAINE COAST MEMORIAL HOSPITAL (ToBeTerminated)
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Main Details
Name
MAINE COAST MEMORIAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH200050-00
Medicare Provider Number
200050
Additional Details
Current Program Status
ToBeTerminated
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
3/12/2020
Last Recertification Date
9/9/2024
Termination Date
Termination Reason
7/1/2025
Change of covered entity type
Contacts
Authorizing Official
Maine Coast Hospital
Wendy June Merchant, VP of Finance
(207) 610-2429
Primary Contact
Northern Light Health
Corey Michael Taylor, Director of Pharmacy
(207) 664-5468
Addresses
Street Address
50 UNION STREET
ELLSWORTH, ME 04605
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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