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EXPRESS SCRIPTS PHARMACY, INC.
CH01458AG PENOBSCOT COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
PENOBSCOT COMMUNITY HEALTH CENTER, INC.
Subdivision Name
DIRIGO PINES RETIREMENT COMMUNITY
Type
HRSA-Funded Health Center
340B ID
CH01458AG
Entity Address
9 ALUMNI DRIVE
ORONO, ME 04473
Grant Number
H80CS04291
Participating Start Date
1/1/2007
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
EXPRESS SCRIPTS PHARMACY, INC.
Pharmacy Address
DBA EXPRESS SCRIPTS
2040 ROUTE 130 NORTH
BURLINGTON, NJ 08016
Pharmacy Comments
Contract Details
Approval Date
4/19/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lorelle Dwyer, President & CEO
(207) 992-9200
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/19/2024
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