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CAH201312-26 WALDO COUNTY GENERAL HOSPITAL (Terminated)
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Main Details
Name
WALDO COUNTY GENERAL HOSPITAL
Subdivision Name
WCMP RESPIRATORY HEALTH CENTER - Respiratory
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH201312-26
Medicare Provider Number
201312
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2021
Participating Start Date
10/1/2021
Participating Approval Date
7/22/2021
Last Recertification Date
8/29/2022
Termination Date
Termination Reason
4/1/2023
Site closure
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
125 NORTHPORT AVE
STE 106
Belfast, ME 04915
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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