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RITE AID OF MAINE, INC.
CAH301307-00 MaineHealth Memorial Hospital
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Covered Entity Details
Entity Name
MaineHealth Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH301307-00
Entity Address
3073 White Mountain Hwy
North Conway, NH 03860-7101
Medicare Provider Number
301307
Participating Start Date
10/1/2011
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
RITE AID OF MAINE, INC.
Pharmacy Address
RITE AID #4162
119 BRIDGTON ROAD
FRYEBURG, ME 04037
Pharmacy Comments
Contract Details
Approval Date
7/3/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/16/2018
Agreement registered in error
Contacts
Covered Entity Signing Official
Diana J. McLaughlin, Chief Financial Officer
(603) 356-0613 Ext: 2537
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/3/2018
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