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SHAWS SUPERMARKETS INC
CH01517C SEBASTICOOK FAMILY DOCTORS
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Covered Entity Details
Entity Name
SEBASTICOOK FAMILY DOCTORS
Subdivision Name
FAMILY DOCTORS - DEXTER
Type
HRSA-Funded Health Center
340B ID
CH01517C
Entity Address
29 Church St
Dexter, ME 04930-1320
Grant Number
H80CS02448
Participating Start Date
7/1/2005
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
SHAWS SUPERMARKETS INC
Pharmacy Address
SHAWS PHARMACY #0629
1073 W. MAIN ST
DOVER FOXCROFT, ME 04426
Pharmacy Comments
Contract Details
Approval Date
1/10/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robin Winslow, CEO
(207) 368-4213
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
1/10/2025
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