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M DRUG LLC
CH014580 PENOBSCOT COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
PENOBSCOT COMMUNITY HEALTH CENTER, INC.
Subdivision Name
BREWER MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH014580
Entity Address
735 WILSON ST
BREWER, ME 04412
Grant Number
H80CS04291
Participating Start Date
1/1/2005
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
M DRUG LLC
Pharmacy Address
DBA NORTHERN LIGHT PHARMACY WESTGATE
915 UNION ST STE 7
BANGOR, ME 04401-8604
Pharmacy Comments
Contract Details
Approval Date
5/22/2025
Contract Begin Date
5/22/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lorelle Dwyer, President & CEO
(207) 992-9200
Contract Pharmacy Representative
M DRUG llc
Matthew Marston, Interim Director
(207) 275-3239
Signed By Date
5/22/2025
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