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CHC25680-14 Portland Community Health Center (Terminated)
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Main Details
Name
Portland Community Health Center
Subdivision Name
Greater Portland Health at Sagamore Village
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032140
340B ID
CHC25680-14
Grant Number
H80CS25680
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2021
Participating Start Date
10/1/2021
Participating Approval Date
7/14/2021
Last Recertification Date
2/23/2024
Termination Date
Termination Reason
10/1/2024
Site closure
Contacts
Authorizing Official
Portland Community Health Center
Ann Tucker, Chief Executive Officer
(207) 874-2141 Ext: 3886
Primary Contact
Portland Community Health Center
Tara Leblanc, Director of HR & Financial Reporting
(207) 874-2141
Addresses
Street Address
68 Popham St
Portland, ME 04102-1151
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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