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M DRUG LLC DBA MILLER DRUG WESTGATE
CH014580 PENOBSCOT COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
PENOBSCOT COMMUNITY HEALTH CENTER, INC.
Subdivision Name
BREWER MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH014580
Entity Address
735 WILSON ST
BREWER, ME 04412
Grant Number
H80CS04291
Participating Start Date
1/1/2005
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
M DRUG LLC DBA MILLER DRUG WESTGATE
Pharmacy Address
915 UNION STREET
SUITE 7
BANGOR, ME 04401
Pharmacy Comments
Contract Details
Approval Date
8/29/2012
Contract Begin Date
9/7/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ken Schmidt, CEO
(207) 945-5247 Ext: 401
Contract Pharmacy Representative
Kent Bridges, Executive Director
(207) 973-6789
Signed By Date
8/31/2012
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