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EXPRESS SCRIPTS
CHC25680-08 PORTLAND COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
PORTLAND COMMUNITY HEALTH CENTER
Subdivision Name
Greater Portland Health at King Middle School
Type
HRSA-Funded Health Center
340B ID
CHC25680-08
Entity Address
92 Deering Ave
Portland, ME 04102-2990
Grant Number
H80CS25680
Participating Start Date
1/1/2017
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
EXPRESS SCRIPTS
Pharmacy Address
ESI MAIL PHARMACY SERVICE INC
4600 N HANLEY RD
SAINT LOUIS, MO 63134
Pharmacy Comments
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ann Tucker, Chief Executive Officer
(207) 874-2141 Ext: 3886
Contract Pharmacy Representative
Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/17/2023
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