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NEW ENGLAND LIFE CARE
HM04101 MAINE MEDICAL CENTER
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Covered Entity Details
Entity Name
MAINE MEDICAL CENTER
Subdivision Name
MAINE HEMOPHILIA AND THROMBOSIS CENTER
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM04101
Entity Address
22 BRAMHALL ST
PORTLAND, ME 04101
Grant Number
H30MC24048
Participating Start Date
4/1/2008
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
NEW ENGLAND LIFE CARE
Pharmacy Address
45 CENTER STREET SUITE A
SCARBOROUGH, ME 04074
Pharmacy Comments
Contract Details
Approval Date
10/8/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ALBERT G. SWALLOW, Vice President of Finance
(207) 662-3998
Contract Pharmacy Representative
NE Life Care
Michael Souza, President
(800) 439-7969
Signed By Date
10/8/2013
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