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COMMUNITY PHARMACY OF DEXTER
CH01517C SEBASTICOOK FAMILY DOCTORS
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Covered Entity Details
Entity Name
SEBASTICOOK FAMILY DOCTORS
Subdivision Name
FAMILY DOCTORS - DEXTER
Type
HRSA-Funded Health Center
340B ID
CH01517C
Entity Address
29 Church St
Dexter, ME 04930-1320
Grant Number
H80CS02448
Participating Start Date
7/1/2005
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
COMMUNITY PHARMACY OF DEXTER
Pharmacy Address
37 CHURCH STREET
DEXTER, ME 04930-1333
Pharmacy Comments
Contract Details
Approval Date
10/20/2011
Contract Begin Date
7/29/2005
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
5/27/2005
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