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WALGREEN EASTERN CO., INC.
CAH201300-00 BLUE HILL MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
BLUE HILL MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH201300-00
Entity Address
57 WATER STREET
BLUE HILL, ME 04614
Medicare Provider Number
201300
Participating Start Date
1/1/2011
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #11742
226 HIGH STREET
ELLSWORTH, ME 04605-1742
Pharmacy Comments
Contract Details
Approval Date
4/11/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Wendy J Jones, VP of Finance
(207) 374-3409
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/11/2019
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