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CAH201312-27 MAINEHEALTH WALDO HOSPITAL (Active)
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Main Details
Name
MAINEHEALTH WALDO HOSPITAL
Subdivision Name
WCMP Palliative Care - WCMP Palliative Care
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH201312-27
Medicare Provider Number
201312
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/6/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/10/2023
Last Recertification Date
8/24/2024
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
106
Belfast, ME 04915
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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