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WALGREEN EASTERN CO., INC.
CH01328C D.F.D. RUSSELL MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
D.F.D. RUSSELL MEDICAL CENTER, INC.
Subdivision Name
DFD RUSSELL MEDICAL CENTER - BRIDGTON
Type
HRSA-Funded Health Center
340B ID
CH01328C
Entity Address
25 Hospital Dr
Bridgton, ME 04009-1167
Grant Number
H80CS00642
Participating Start Date
1/1/2022
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #17364
19 PORTLAND RD
BRIDGTON, ME 04009-1229
Pharmacy Comments
Contract Details
Approval Date
4/11/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laurie Kane-Lewis, CEO
(207) 524-4001
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/11/2024
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