340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CVS STATE CAPITAL, L.L.C.
DSH200034 St. Mary's Regional Medical Center
Print
Covered Entity Details
Entity Name
St. Mary's Regional Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH200034
Entity Address
93 Campus Avenue
Lewiston, ME 04240-6030
Medicare Provider Number
200034
Participating Start Date
10/1/2002
Last Recertification Date
8/19/2024
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
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Hendrix, CFO/Treasurer
(207) 777-8865
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session