340B Drug Pricing Program Database
F E LESLIE DRUGGIST INC
CAH221300-00 MARTHA'S VINEYARD HOSPITAL - information as of 6/28/2025 12:46:29 AM
Covered Entity Details
Entity Name
MARTHA'S VINEYARD HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH221300-00
Entity Address
1 HOSPITAL ROAD
Oak Bluffs, MA 02557
Medicare Provider Number
221300
Participating Start Date
9/24/2010
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
F E LESLIE DRUGGIST INC
Pharmacy Address
65-12 MAIN STREET
PO BOX 417
VINEYARD HAVEN, MA 02568
Pharmacy Comments
Contract Details
Approval Date
10/12/2012
Contract Begin Date
10/12/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DAVID Taber CARON, PHARMACY DIRECTOR
(508) 957-9512
Contract Pharmacy Representative
FE Leslie Druggist Inc.
Warren Holmberg, Owner
(508) 693-6229
Signed By Date
9/14/2012
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session