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HANNAFORD BROS. CO., LLC
CH01458AW PENOBSCOT COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
PENOBSCOT COMMUNITY HEALTH CENTER, INC.
Subdivision Name
CAPEHART COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH01458AW
Entity Address
86 DAVIS ROAD
BANGOR, ME 04401
Grant Number
H80CS04291
Participating Start Date
1/1/2007
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
HANNAFORD BROS. CO., LLC
Pharmacy Address
DBA HANNAFORD SUPERMARKET & PHARMACY #81
1133 UNION ST
BANGOR, ME 04401
Pharmacy Comments
Contract Details
Approval Date
7/20/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lorelle Dwyer, President & CEO
(207) 992-9200
Contract Pharmacy Representative
Hannaford Bros. Co., LLc
Deanne Sargent, Manager Pharmacy Network & Buisness Development
(207) 885-3044
Signed By Date
7/20/2024
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