Contract Pharmacy Details

MAXI DRUG NORTH, INC.
CH010760C Amoskeag Health

Covered Entity Details

Entity Name

Amoskeag Health

Subdivision Name

Amoskeag Health at 88 McGregor Street

Type

HRSA-Funded Health Center

340B ID

CH010760C

Entity Address

88 MCGREGOR ST
MANCHESTER, NH 03102-3750

Grant Number

H80CS00571

Participating Start Date

4/1/2016

Last Recertification Date

1/29/2024

Entity Termination Date

4/1/2025

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

340B Drug Pricing Program Database