340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CVS STATE CAPITAL, L.L.C.
CHC25680-07 PORTLAND COMMUNITY HEALTH CENTER
Print
Covered Entity Details
Entity Name
PORTLAND COMMUNITY HEALTH CENTER
Subdivision Name
Greater Portland Health at Deering High School
Type
HRSA-Funded Health Center
340B ID
CHC25680-07
Entity Address
370 Stevens Ave
Portland, ME 04103-2607
Grant Number
H80CS25680
Participating Start Date
1/1/2017
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
CVS STATE CAPITAL, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00143
384 ELM ST.
BIDDEFORD, ME 04005
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ann Tucker, Chief Executive Officer
(207) 874-2141 Ext: 3886
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2021
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