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COMMUNITY PHARMACY OF BUCKSPORT
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
COMMUNITY PHARMACY OF BUCKSPORT
Pharmacy Address
75 MAIN ST.
BUCKSPORT, ME 04416
Pharmacy Comments
Contract Details
Approval Date
1/12/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lorelle Dwyer, President & CEO
(207) 992-9200
Contract Pharmacy Representative
Community Pharmacy, LP
Amelia Arnold, Clinical Pharmacist
(207) 621-0698 Ext: 228
Signed By Date
1/12/2022
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