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WALGREEN EASTERN CO., INC.
CH01458BD PENOBSCOT COMMUNITY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
PENOBSCOT COMMUNITY HEALTH CENTER, INC
Subdivision Name
Jackman Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH01458BD
Entity Address
376 Main St
Jackman, ME 04945-5214
Grant Number
H80CS04291
Participating Start Date
7/1/2014
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #11545
437 WILSON ST
BREWER, ME 04412
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
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/19/2024
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