Contract Pharmacy Details

RITE AID OF MAINE, INC.
CH01458W PENOBSCOT COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

PENOBSCOT COMMUNITY HEALTH CENTER, INC.

Subdivision Name

PENOBSCOT PEDIATRICS

Type

HRSA-Funded Health Center

340B ID

CH01458W

Entity Address

6 Telcom Drive
BANGOR, ME 04401

Grant Number

H80CS04291

Participating Start Date

1/1/2007

Last Recertification Date

3/6/2025

Pharmacy Details

Pharmacy Name

RITE AID OF MAINE, INC.

Pharmacy Address

RITE AID #3293
226 UNION STREET
BANGOR, ME 04401

Pharmacy Comments

Contract Details

Approval Date

2/28/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/9/2018
Ownership change

Contacts

Covered Entity Signing Official

Ken Schmidt, CEO
(207) 945-5247 Ext: 401

Contract Pharmacy Representative

Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217

Signed By Date

1/15/2013

340B Drug Pricing Program Database