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ACCREDO HEALTH GROUP, INC.
DSH200033 EASTERN MAINE MEDICAL CENTER
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Covered Entity Details
Entity Name
EASTERN MAINE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH200033
Entity Address
489 STATE STREET
BANGOR, ME 04401
Medicare Provider Number
200033
Participating Start Date
10/1/2003
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
4750 E 450 S
SUITE A
WHITESTOWN, IN 46075
Pharmacy Comments
Contract Details
Approval Date
1/18/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Philippe Morissette, SVP of Finance
(207) 973-6488
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/18/2022
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