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MAXI DRUG NORTH, INC.
CH011580 LAMPREY HEALTH CARE
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Covered Entity Details
Entity Name
LAMPREY HEALTH CARE
Subdivision Name
LAMPREY HEALTH CARE
Type
HRSA-Funded Health Center
340B ID
CH011580
Entity Address
207 S MAIN ST.
NEWMARKET, NH 03857
Grant Number
H80CS00640
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MAXI DRUG NORTH, INC.
Pharmacy Address
RITE AID #10295
5 MILL RD. UNIT G
DURHAM, NH 03824
Pharmacy Comments
Contract Details
Approval Date
10/7/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gregory White, CEO
(603) 659-2494 Ext: 7214
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
10/7/2019
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