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DAVIS PHARMACY
CH01511L HEALTH ACCESS NETWORK, INC.
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Covered Entity Details
Entity Name
HEALTH ACCESS NETWORK, INC.
Subdivision Name
HAN MEDWAY
Type
HRSA-Funded Health Center
340B ID
CH01511L
Entity Address
1930 MEDWAY RD
MEDWAY, ME 04460-3166
Grant Number
H80CS02450
Participating Start Date
7/1/2005
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
DAVIS PHARMACY
Pharmacy Address
59 MAIN STREET
EAST MILLINOCKET, ME 04430
Pharmacy Comments
Contract Details
Approval Date
10/20/2011
Contract Begin Date
7/1/2005
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/12/2018
Agreement registered in error
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
6/29/2005
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