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WALGREEN EASTERN CO., INC.
SCH200037-00 Franklin Memorial Hospital
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Covered Entity Details
Entity Name
Franklin Memorial Hospital
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH200037-00
Entity Address
111 Franklin Health Commons
Farmington, ME 04938
Medicare Provider Number
200037
Participating Start Date
7/1/2017
Last Recertification Date
9/5/2023
Entity Termination Date
8/20/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #17159
7 PORTLAND ST
RUMFORD, ME 04276
Pharmacy Comments
Contract Details
Approval Date
4/9/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/20/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Miriam A Leonard, Chief Operating Officer
(207) 779-2265
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/9/2019
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