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HEBERT REXALL PHARMACY, INC
CHC08769-00 PINES HEALTH SERVICES
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Covered Entity Details
Entity Name
PINES HEALTH SERVICES
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CHC08769-00
Entity Address
74 ACCESS HIGHWAY
CARIBOU, ME 04736
Grant Number
H80CS08769
Participating Start Date
4/1/2009
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HEBERT REXALL PHARMACY, INC
Pharmacy Address
31 MAIN ST
P.O. BOX 220
VAN BUREN, ME 04785-1012
Pharmacy Comments
Contract Details
Approval Date
7/16/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kris Doody, CEO
(207) 498-2356
Contract Pharmacy Representative
Hebert Rexall Pharmacy Inc
John Hebert, Owner/PIC
(207) 868-2242
Signed By Date
7/16/2018
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