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HANNAFORD BROS. CO., LLC
CAH201300-00 BLUE HILL MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
BLUE HILL MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH201300-00
Entity Address
57 WATER STREET
BLUE HILL, ME 04614
Medicare Provider Number
201300
Participating Start Date
1/1/2011
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
HANNAFORD BROS. CO., LLC
Pharmacy Address
DBA HANNAFORD SUPERMARKET & PHARMACY #81
STE 1 225 HIGH ST
ELLSWORTH, ME 04605
Pharmacy Comments
Contract Details
Approval Date
7/14/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Wendy J Jones, VP of Finance
(207) 374-3409
Contract Pharmacy Representative
Hannaford Bros. Co., LLc
Deanne Sargent, Manager Pharmacy Network & Buisness Development
(207) 885-3044
Signed By Date
7/14/2020
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