Contract Pharmacy Details

MAXI DRUG, INC.
CH010170 Harbor Health Services, Inc.

Covered Entity Details

Entity Name

Harbor Health Services, Inc.

Subdivision Name

DANIEL DRISCOLL - NEPONSET HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH010170

Entity Address

398 NEPONSET AVE
DORCHESTER, MA 02122

Grant Number

H80CS00743

Participating Start Date

4/1/2002

Last Recertification Date

2/27/2025

Pharmacy Details

Pharmacy Name

MAXI DRUG, INC.

Pharmacy Address

RITE AID #10191
711 MAIN ST. ROUTE 28
DENNIS PORT, MA 02639

Pharmacy Comments

Contract Details

Approval Date

7/12/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/27/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

DANIEL J. DRISCOLL, CEO
(617) 533-2300

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

7/12/2016

340B Drug Pricing Program Database