340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MAXI DRUG, INC.
CH010600 FENWAY COMMUNITY HEALTH CENTER, INC.
Print
Covered Entity Details
Entity Name
FENWAY COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Fenway Health, Ansin Building
Type
HRSA-Funded Health Center
340B ID
CH010600
Entity Address
1340 Boylston St
Boston, MA 02215
Grant Number
H80CS00303
Participating Start Date
1/1/2004
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
MAXI DRUG, INC.
Pharmacy Address
RITE AID #10150
1100 DORCHESTER AVENUE
DORCHESTER, MA 02125
Pharmacy Comments
Contract Details
Approval Date
4/11/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JEFFREY LIEBERMAN, VP of Finance
(617) 927-6173
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
4/11/2014
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