Contract Pharmacy Details

SHAWS SUPERMARKETS INC
RRC200024-00 CENTRAL MAINE MEDICAL CENTER

Covered Entity Details

Entity Name

CENTRAL MAINE MEDICAL CENTER

Subdivision Name

Type

Rural Referral Center

340B ID

RRC200024-00

Entity Address

300 MAIN STREET
LEWISTON, ME 04240-4500

Medicare Provider Number

200024

Participating Start Date

10/1/2017

Last Recertification Date

9/13/2021

Entity Termination Date

4/1/2022

Pharmacy Details

Pharmacy Name

SHAWS SUPERMARKETS INC

Pharmacy Address

SHAWS PHARMACY #4559
27 EAST AVE
LEWISTON, ME 04240

Pharmacy Comments

Contract Details

Approval Date

7/17/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2022
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Sean Cheetham, Taxation Manager
(207) 795-7533

Contract Pharmacy Representative

Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304

Signed By Date

7/17/2018

340B Drug Pricing Program Database