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MAXI DRUG NORTH, INC.
CH010760B Amoskeag Health
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Covered Entity Details
Entity Name
Amoskeag Health
Subdivision Name
Amoskeag Health at 1245 Elm Street
Type
HRSA-Funded Health Center
340B ID
CH010760B
Entity Address
1245 ELM ST
MANCHESTER, NH 03101-1308
Grant Number
H80CS00571
Participating Start Date
4/1/2015
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MAXI DRUG NORTH, INC.
Pharmacy Address
RITE AID #10276
53 HOOKSETT ROAD
MANCHESTER, NH 03104
Pharmacy Comments
Contract Details
Approval Date
7/5/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/31/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kris McCracken, President/CEO
(603) 935-5210
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
7/5/2018
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