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KENNEBEC PHARMACY & HOMECARE
CH010450 ISLANDS COMMUNITY MEDICAL SERVICES, INC.
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Covered Entity Details
Entity Name
ISLANDS COMMUNITY MEDICAL SERVICES, INC.
Subdivision Name
ISLANDS COMMUNITY MEDICAL SERVICES
Type
HRSA-Funded Health Center
340B ID
CH010450
Entity Address
15 MEDICAL CENTER LOOP
VINALHAVEN, ME 04863-4104
Grant Number
H80CS06657
Participating Start Date
10/1/2004
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
KENNEBEC PHARMACY & HOMECARE
Pharmacy Address
839 COMMERCIAL ST
ROCKPORT, ME 04856-4243
Pharmacy Comments
Contract Details
Approval Date
4/1/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DINAH MOYER, EXECUTIVE DIRECTOR
(207) 863-9071
Contract Pharmacy Representative
Community Pharmacy
Amelia Arnold, Vice President
(207) 593-1692
Signed By Date
4/1/2025
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