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HANNAFORD BROS. CO., LLC
CHC00630-00 EASTPORT HEALTH CARE INC
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Covered Entity Details
Entity Name
EASTPORT HEALTH CARE INC
Subdivision Name
EASTPORT HEALTH CARE, INC.
Type
HRSA-Funded Health Center
340B ID
CHC00630-00
Entity Address
30 Boynton St
Eastport, ME 04631-1306
Grant Number
H80CS00630
Participating Start Date
7/1/2015
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HANNAFORD BROS. CO., LLC
Pharmacy Address
DBA HANNAFORD SUPERMARKET & PHARMACY #81
149 DUBLIN STREET
MACHIAS, ME 04654
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ellen M Krajewski, CEO
(207) 853-4045
Contract Pharmacy Representative
Hannaford Bros. Co., LLc
Deanne Sargent, Manager Pharmacy Network & Buisness Development
(207) 885-3044
Signed By Date
7/15/2020
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