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CVS STATE CAPITAL, L.L.C.
CH010460 HEALTHREACH COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
HEALTHREACH COMMUNITY HEALTH CENTERS
Subdivision Name
BINGHAM AREA HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH010460
Entity Address
237 Main St
Bingham, ME 04920
Grant Number
H80CS00797
Participating Start Date
10/1/2001
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
CVS STATE CAPITAL, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04158
24 STONE ST., STE120
AUGUSTA, ME 04330
Pharmacy Comments
Contract Details
Approval Date
7/14/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
CONSTANCE COGGINS, CEO
(207) 872-5610
Contract Pharmacy Representative
CVS Caremark
JACKLYN PARFITT, MANAGER, PAYER RELATIONS
(401) 770-6467
Signed By Date
7/14/2015
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