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ARCADIA MEDICAL PHARMACY,INC.
CHC25680-17 PORTLAND COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
PORTLAND COMMUNITY HEALTH CENTER
Subdivision Name
Greater Portland Health at 934 Congress Street
Type
HRSA-Funded Health Center
340B ID
CHC25680-17
Entity Address
934 Congress St
Portland, ME 04102-3032
Grant Number
H80CS25680
Participating Start Date
4/1/2023
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
ARCADIA MEDICAL PHARMACY,INC.
Pharmacy Address
DBA ARCADIA MEDICAL PHARMACY
612 W. DUARTE RD #102
ARCADIA, CA 91007
Pharmacy Comments
Contract Details
Approval Date
5/3/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/21/2024
Agreement registered in error
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
5/3/2023
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