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HANNAFORD BROS. CO., LLC
CHC08769-00 PINES HEALTH SERVICES
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Covered Entity Details
Entity Name
PINES HEALTH SERVICES
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CHC08769-00
Entity Address
74 ACCESS HIGHWAY
CARIBOU, ME 04736
Grant Number
H80CS08769
Participating Start Date
4/1/2009
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HANNAFORD BROS. CO., LLC
Pharmacy Address
DBA HANNAFORD SUPERMARKET & PHARMACY #84
114 HIGH STREET
CARIBOU, ME 04736
Pharmacy Comments
Contract Details
Approval Date
1/14/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kris Doody, CEO
(207) 498-2356
Contract Pharmacy Representative
340B Direct
Jodi Lewis, Client Account Manager
(877) 828-9420 Ext: 136
Signed By Date
1/14/2021
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