Contract Pharmacy Details

M DRUG LLC
DSH200018 THE AROOSTOOK MEDICAL CENTER

Covered Entity Details

Entity Name

THE AROOSTOOK MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH200018

Entity Address

140 ACADEMY STREET
PRESQUE ISLE, ME 04769

Medicare Provider Number

200018

Participating Start Date

7/1/2016

Last Recertification Date

9/9/2024

Pharmacy Details

Pharmacy Name

M DRUG LLC

Pharmacy Address

DBA NORTHERN LIGHT PHARMACY WHITING HILL
33 WHITING HILL RD STE 4
BREWER, ME 04412-1022

Pharmacy Comments

Contract Details

Approval Date

1/14/2019

Contract Begin Date

4/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Maura Kelly, CFO
(207) 768-4737

Contract Pharmacy Representative

M DRUG llc
Matthew Marston, Interim Director
(207) 275-3239

Signed By Date

1/14/2019

340B Drug Pricing Program Database