340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walgreens Central Fill #21400
DSH200001 ST JOSEPH HOSPITAL
Print
Covered Entity Details
Entity Name
ST JOSEPH HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH200001
Entity Address
360 BROADWAY
BANGOR, ME 04401
Medicare Provider Number
200001
Participating Start Date
1/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
Walgreens Central Fill #21400
Pharmacy Address
44 Cabot Blvd.
Mansfield, MA 02048
Pharmacy Comments
Contract Details
Approval Date
4/10/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Allan Hendrix, Vice of President of Finance
(207) 907-1600
Contract Pharmacy Representative
Walgreens
Ruthann Archer, Director of 340B Operations
(847) 964-8116
Signed By Date
4/10/2025
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session