340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
APOTHECARY RX
FQHCLA119N Community Clinical Services, Inc.
Print
Covered Entity Details
Entity Name
Community Clinical Services, Inc.
Subdivision Name
Lewiston Middle School-Based Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA119N
Entity Address
75 Central Avenue
Lewiston, ME 04240-6031
Grant Number
LALCS00085
Participating Start Date
10/1/2004
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
APOTHECARY RX
Pharmacy Address
THE MEDICINE SHOPPE
373 SABATTUS ST
LEWISTON, ME 04240
Pharmacy Comments
Contract Details
Approval Date
10/11/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2016
Agreement registered in error
Contacts
Covered Entity Signing Official
JAMES LYSEN, EXECUTIVE DIRECTOR
(207) 513-3897
Contract Pharmacy Representative
LANA HOANG, OWNER/MANAGER
(207) 783-3539
Signed By Date
10/11/2013
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