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WESTERN MAINE PHARMACY, INC.
CH01046N HEALTHREACH COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
HEALTHREACH COMMUNITY HEALTH CENTERS
Subdivision Name
BETHEL FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH01046N
Entity Address
32 Railroad St
Bethel, ME 04217
Grant Number
H80CS00797
Participating Start Date
10/1/2001
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WESTERN MAINE PHARMACY, INC.
Pharmacy Address
WESTERN MAINE PHARMACY
119 MAIN ST
KINGFIELD, ME 04947
Pharmacy Comments
12/15/2011 removed PO Box 64
Contract Details
Approval Date
11/10/2011
Contract Begin Date
11/18/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
CONSTANCE COGGINS, CEO
(207) 872-5610
Contract Pharmacy Representative
Audrey Parks, Owner / Pharmacist
(207) 265-8020
Signed By Date
11/11/2011
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