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HANNAFORD BROS. CO., LLC
CH01517B SEBASTICOOK FAMILY DOCTORS
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Covered Entity Details
Entity Name
SEBASTICOOK FAMILY DOCTORS
Subdivision Name
Sebasticook Family Doctors
Type
HRSA-Funded Health Center
340B ID
CH01517B
Entity Address
118 MOOSEHEAD TRAIL
STE 5
NEWPORT, ME 04953
Grant Number
H80CS02448
Participating Start Date
7/1/2005
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
HANNAFORD BROS. CO., LLC
Pharmacy Address
DBA SUPERMARKET & PHARMACY #8443
44 MOOSEHEAD TRAIL
NEWPORT, ME 04953
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
Robin Winslow, CEO
(207) 368-4213
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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