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WAL-MART PHARMACY 10-1788
CHC00458-00 SACOPEE VALLEY HEALTH CENTER
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Covered Entity Details
Entity Name
SACOPEE VALLEY HEALTH CENTER
Subdivision Name
SACOPEE VALLEY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC00458-00
Entity Address
70 Main St
Porter, ME 04068
Grant Number
H80CS00458
Participating Start Date
7/1/2009
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1788
Pharmacy Address
500 GALLERY BLVD
SCARBOROUGH, ME 04074
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/18/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Michelle Eastman, Chief Financial Officer
(207) 625-2235
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/16/2023
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