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DSH200024AZ CENTRAL MAINE MEDICAL CENTER (Terminated)
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Main Details
Name
CENTRAL MAINE MEDICAL CENTER
Subdivision Name
Central Maine Therapy Services OT - Occupational Therapy
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH200024AZ
Medicare Provider Number
200024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2022
Participating Start Date
7/1/2022
Participating Approval Date
4/28/2022
Last Recertification Date
9/11/2023
Termination Date
Termination Reason
10/1/2024
Never implemented the 340B Program
Contacts
Authorizing Official
Central Maine Healthcare
Steve Littleson, Interim President & CEO
(207) 795-2947
Primary Contact
Central Maine Healthcare
Marcia Gooden, 340B Program Manager
(207) 795-2325
Addresses
Street Address
17 High Street
Lewiston, ME 04240
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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