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HV30726A Portland Community Health Center (Terminated)
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Main Details
Name
Portland Community Health Center
Subdivision Name
Type
Ryan White Part C
340B ID
HV30726A
Grant Number
H76HA30726
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/18/2020
Last Recertification Date
2/15/2022
Time Period the Assistance was Received
1/1/2018 - 12/31/2021
Termination Date
Termination Reason
4/1/2023
Never implemented the 340B Program
Contacts
Authorizing Official
Portland Community Health Center
Ann Tucker, Chief Executive Officer
(207) 874-2141 Ext: 3886
Primary Contact
Portland Community Health Center
Elizabeth Jackson, Chief Operating Officer
(207) 874-2141 Ext: 5023
Addresses
Street Address
92 Deering Avenue
Portland, ME 04102
Billing Address
Portland Community Health Center
180 Park Avenue
Portland, ME 04102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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