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SHAWS SUPERMARKETS INC
CAH301312-00 HUGGINS HOSPITAL
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Covered Entity Details
Entity Name
HUGGINS HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH301312-00
Entity Address
240 SOUTH MAIN STREET
WOLFEBORO, NH 03894-0912
Medicare Provider Number
301312
Participating Start Date
9/29/2010
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
SHAWS SUPERMARKETS INC
Pharmacy Address
SHAWS PHARMACY #2403
1150 EASTMAN RD
CENTER CONWAY, NH 03813
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/31/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jeremy Roberge, CEO
(603) 569-7507
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
1/13/2020
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