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Walgreens Central Fill #21400
CH015110 HEALTH ACCESS NETWORK
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Covered Entity Details
Entity Name
HEALTH ACCESS NETWORK
Subdivision Name
Health Access Network Lincoln
Type
HRSA-Funded Health Center
340B ID
CH015110
Entity Address
175 WEST BROADWAY
LINCOLN, ME 04457
Grant Number
H80CS02450
Participating Start Date
1/1/2004
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
Walgreens Central Fill #21400
Pharmacy Address
44 Cabot Blvd.
Mansfield, MA 02048
Pharmacy Comments
Contract Details
Approval Date
7/10/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Wanda T Kimball, Chief Financial Officer
(207) 403-7516
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/10/2023
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